Abstracts

Rationale: Photosensitivity is known to trigger seizures in epilepsy patients, and has a detection rate of 5% on EEG. This photoparoxysmal response (PPR) is often subclinical and unrecognized, and therefore can compromise patients’ abilities to perform their daily tasks, do well in school, and may precipitate seizures. The objective of this study is to further investigate the use of blue lenses in reducing PPR in epileptics. We propose that the use of blue lenses may suppress the PPR by altering luminance and wavelength of light.Methods: Thus far 26 pediatric patients with Type 4 PPR (Waltz et al.) were tested with photic stimulation with and without a blue lens from 1 – 21 Hz. Twenty one patients had primary generalized epilepsy, 2 had Dravet’s Syndrome, and 3 patients had epilepsy with various seizure types.Results: Responses were classified into 3 groups: PPR resolution, persistence or attenuation with blue lens testing. The PPR was eliminated in 7 patients, attenuated in 15, but persisted in 4. We also used cobalt blue polarized (Z1) sunglasses in some patients, and PPR attenuation was observed as well. Eleven patients were not on any antiepileptic medications; of these 4 had complete and 5 partial resolution of the PPR. Five of 6 patients on Levetiracetam and 4 of 4 on Valproic Acid responded as well.Conclusions: Blue lenses reduced the PPR in 22 of 26 patients. Possible mechanisms include polarization, reduction of luminance, and filtering of red light. Further testing of photosensitive patients will be performed. Comparisons will be made between different lenses; blue, Z1 and red lenses. We will also further quantify the degree of improvement and analyze possible synergistic effects of AEDs with colored lenses.