Telephone-Induced Seizures: A New Type of Reflex Epilepsy
Abstract number :
2.102
Submission category :
Year :
2001
Submission ID :
2824
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
R. Michelucci, MD, Neurological Sciences, Bellaria Hospital, Bologna, Italy; D.G.A. Kasteleijn-Nolst Trenite[ssquote], MD, Stichting Epilepsie Instellingen, Heemstede, Netherlands; E. Gardella, MD, Neurological Clinic-University, Bologna, Italy; J.P.A. Sa
RATIONALE: To report a previously unrecognized form of reflex epilepsy, in which seizures are only induced by answering the phone.
METHODS: Two young patients with a history of [dsquote]telephone-induced[dsquote] seizures were detected. The patients underwent a full study including detailed seizure history, neurological examination, routine and sleep EEG, MRI, SPECT (in one patient) and video-EEG monitoring with appropriate triggering stimuli in the attempt to pick-up the seizures.
RESULTS: Both patients,a female aged 21 and a male aged 30,were strikingly similar in respect to seizure history and EEG results.They had a 2 year history of complex partial seizures or secondarily generalized seizures, induced exclusively by answering the phone,including a mobile phone. The seizures were characterized by a subjective feeling of dizziness, distortion of sound and speech difficulties; loss of contact and secondary generalization could follow. Neurological examination and MRIs were normal.In the female patient interictal routine and sleep EEGs were without abnormalities except for rare right temporal lobe slow waves.In the male patient some spontaneous isolated epileptiform EEG discharges in the right fronto-temporal region were seen during a 24 hour recording after VPA withdrawal. Interictal SPECT (female patient) was normal. Video-EEG recording of one seizure (female patient) was obtained by reproducing in the lab the effective sequence of events: telephone ringing, picking up the receiver and hearing the calling voice. The seizure showed a clear cut right temporal lobe onset. In both patients, antiepileptic therapy resulted in disappearance of seizures.
CONCLUSIONS: This is the first report of a previously unrecognized form of reflex epilepsy in which temporal lobe seizures are induced by answering the phone. In our cases, it is conceivable that a complex sequence of events may activate the auditory cortex or related association areas, thus triggering an epileptic focus over the right temporal lobe and inducing the seizures.