Abstracts

Rationale: Reflex epilepsy syndromes are important clues for investigating complex mechanisms of epileptogenesis. We present the clinical and EEG characteristics of five eating epilepsy cases, which is a very rare form of reflex epilepsy. Methods: Four males and one female patient (0.0005% of all patients) aged between 25-62 years, had therapy resistant simple partial, complex partial and secondarily generalized seizures triggered with eating besides spontaneous seizures. Results: Their ages at onset were between 10-51 years and all had an initial precipitating event (such as head or birth trauma and neonatal convulsions); interestingly. The seizures mostly associated with having dinner in three patients; but they occurred at the breakfast too, in 2 patients. In 4 neurologically normal patients, the seizures were induced with a longer latency such as in the middle of the meal or even closely after the end, whereas in the last male case with mental retardation and right hemiparesis, the seizures were triggered by swallowing and at the beginning of the meal suggesting two different mechanisms. Three patients had normal MRI s, whereas one had sequel lesions involving the left parieto-occipital regions and one had meningioma involving the left frontal extra axial region. The interictal EEG s showed frequent spikes and slowing over a large area on the left temporal region in 4 and over right temporal area in one of them. The EEG focus persisted for more than 20 years despite extensive anti-epileptic drug treatments in one case. We are able to record eating related seizures originating from the left anterior temporal region in two cases. PET investigations are concordant with the EEG foci in 2 cases. Conclusions: Our study showed that eating epilepsy is extremely rare and occurred usually after a silent period in patients who had an initial precipitating event for epilepsy. The seizures originated from the left temporal region mostly and triggered by dinner or breakfast with a long latency in most of the cases.