Ongoing Photosensitivity in An Elderly Patient With Jeavons Sydrome

Introduction:Photosensitivity, which is a main feature of Jeavons syndrome, can be seen in other types of idiopathic or genetic epilepsies with focal or generalized seizures and tends to disappear spontaneously usually in the second decade. Although it responds well to antiepileptic treatment, especially to valproic acid, it may continue into adulthood in rare cases.Case Report:We describe a 63-year-old male patient with eyelid myoclonia with absences, generalized tonic-clonic seizures, and severe photosensitivity accompanied by eyelid myoclonia. Seizures were treated with antiepileptic treatment, whereas photosensitivity still continued on electroencephalogram without clinical findings.Conclusion:Our elderly patient with Jeavons syndrome with ongoing remarkable photosensitivity demonstrated that it may continue to older ages, although it is uncommon

The Effect of Cognitive Tasks During Electroencephalography Recording in Patients With Reflex Seizures

PubMed: 33356510Objective We aimed to research the effect of cognitive tasks on interictal electroencephalographic (EEG) recordings in patients with epilepsy who had reported cognitive functions as a seizure trigger. We investigated the usefulness of cognitive function tasks as a method of activation in standard-awake EEG in daily practice. Methods Standard-awake EEG with cognitive activation tasks consisting of verbal and arithmetic tasks was administered to 35 (11.7%) of 299 patients with epilepsy who reported cognitive functions as a reflex seizure stimulus. During the background EEG, patients were divided into 2 groups: group 1 (17 patients) with interictal epileptiform discharges (IEDs), and group 2 (18 patients) without IEDs. Results IEDs were activated by a verbal task in 11.4% of patients and by an arithmetic task in 5.7%. All activated patients were in the genetic/idiopathic generalized epilepsy (IGE) group. In group 1, IEDs were activated in 17.6% of patients by a verbal task and in 5.9% by an arithmetic task. Both verbal and arithmetic tasks showed provocative effect in one patient in group 2. Hyperventilation was the most effective activation method, followed by cognitive activation tasks and photic stimulation. The provocative effects of verbal and arithmetic tasks were comparable to those of photic stimulation. Conclusion Cognitive tasks might activate the IEDs in patients reporting cognitive functions as a seizure trigger, particularly in IGE. Brief and standardized cognitive activation tasks should be developed and applied as a method of activation during standard-awake EEG recordings to increase the diagnostic yield of EEG

Trigeminal somatosensorial evoked potentials suggest increased excitability during interictal period in patients with long disease duration in migraine

Introduction: Migraine pathogenesis is suggested to involve many structures in cerebral cortex, brain stem and trigeminovascular system. Electrophysiological studies revealed loss of habituation, decreased cortical preactivation, segmental hypersensitivity and reduction in control of inhibitory descending pathways. Given these information, we aimed to evaluate the excitability changes of the trigeminal pathway in the cortex and brainstem in migraine using trigeminal nerve somatosensory evoked potentials (TSEP)

The prevalence and impact of primary headaches in orphaned children: a cross-sectional, observational study in a boarding school

The relationship between headache and stressful life events experienced in childhood has been found mostly associated with recurrent primary headaches and headache chronicity. We aimed to investigate the prevalence, clinical characteristics, daily life impact of migraine and tension-type headache in orphaned children with low income in a boarding school. Four hundred and fifteen permanent boarders aged 12-17 years were evaluated using the Structured Headache Questionnaire, the Pediatric Migraine Disability Assessment Scale (PedMIDAS), the Strength and Difficulties Questionnaire and Visual Analogue Scale (VAS). Prevalence of primary headache was 59.8%; 24.1% for migraine; 35.7% for tension-type headache; 4.1% for chronic migraine; and 2.4% for chronic tension-type headache. Prevalence of probable diagnoses was found to be higher in early ages; however, definite diagnoses became more common with age. Sex distribution was affected by age in migraineurs. The most distinctive features separating migraine were high frequency, pain severity, throbbing/pounding nature, photophobia, phonophobia, nausea, vomiting, and aggravated by physical activity. Prodromal symptoms and triggering factors were more closely associated with migraine. Sleep was the most common method to relieve of headache, taking medicines was preferred more commonly in migraineurs with a higher mean number of analgesics. Mean VAS, PedMIDAS, and total difficulty scores were higher in migraineurs, emotional problems were found increased in migraine. Headache is underestimated in pediatric population when probable diagnoses are not evaluated. The prevalence of primary headaches and the risk of chronic headaches are high in orphaned students, especially in older adolescent girls, and the effect of headache on daily life is evident

Utility of Amplitudes of Positive Sharp Waves and Fibrillation Potentials

Objective: Fibrillation potentials and positive sharp waves are pathologic spontaneous potentials which originate disconnection anywhere betweenanterior hornof medulla spinalisto muscle fiber in the motor unit. In clinical practice, the presence and if present the intensity of the spontaneous denervation potentials has been evaluated. In this study, the relations between their amplitudes and parameters like lesion duration, lesion type, level of lesion, age of patient and size of recorded muscle were aimed to be examined beside the presence of spontaneous denervation potentials

Pattern of startle reflex to somatosensory stimuli changes after spinal cord injury

Introduction: Spinal cord injury (SCI) may cause functional changes at various levels in central and peripheral nervous systems. One of these changes is increased excitability above the lesion such as enhanced auditory startle responses (ASR). Startle response may also be obtained after somatosensory stimulus (startle reflex to somatosensory stimuli, SSS). In this study, we investigated changes of both ASR and SSS in SCI

Posterior Auricular Muscle Response: Observations in Brainstem Lesions

Objective: Posterior auricular muscle response (PAMR) is a myogenic potential recorded over PAM after auditory stimulation. Its circuit is formed by cochlear and facial nerves with the generator in the brainstem. Here, we investigated whether the addition of a PAMR examination would add additional use in determining or localizing isolated brainstem lesions given that the importance of blink reflex (BR) in determining or localizing brainstem lesions is known. Our hypothesis was that examination of both reflexes would increase clinical utility. Materials and Methods: We included 34 patients with isolated brainstem lesions (multiple sclerosis, ischemic stroke and cerebellopontine angle schwannoma) and 41 healthy subjects. PAMRs were recorded over the PAM after auditory stimulation. BR was elicited by the electrical stimulation of the supraorbital nerve. Results: PAMR was present in 82.9% of healthy subjects, whereas the presence was quite low in the patient group (38.2%, p=0.001). The mean latency of PAMR was delayed in patients compared with healthy subjects (p=0.001). BR was obtained in all healthy subjects, whereas prolonged latencies or absence of BR was observed in the patient group. There were no differences according to the different etiologies or localization. Conclusion: Although the presence of PAMR is quite high, its absence does not always indicate a pathology. However, prolonged latencies almost always suggest an involvement of the PAMR pathway. Likewise, absent PAMR with an abnormal BR provides information for the involvement of brainstem facial nucleus or the proximal part of the facial nerve

Dissociative Aggression Triggered by Headache

Headache is generally perceived as a negative symptom focused on oneself. However, there are reports suggesting that patients suffering from pain, especially headache, can be aggressive. The precise nature of the link between headache and aggression is not known. Here, we describe a homicidal attack, triggered by headache, in a middle-aged man. The patient’s background and the characteristics of the attack suggested a dissociative behavior. The case shows that headache may be a trigger for homicidal behavior. Case-control studies are needed to determine the prevalence of aggressive tendencies in patients with headache