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Motor Manifestations in Epileptic Photosensitivity: Clinical Features and Pathophysiological Insights

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The Importance of Photosensitivity for Epilepsy

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Abstract

A wide spectrum of motor phenomena are associated with epileptic photosensitivity. In this chapter, we will give an overview of the most common clinical manifestations of epileptic photosensitivity focusing in particular on visually induced epileptic motor phenomena such as eyelid myoclonia with absences (EMA) and photic reflex myoclonus (PRM), providing some insights into their pathophysiological mechanisms.

In EMA, current evidences by multimodal imaging and neurophysiological techniques support the hypothesis of an intrinsic “visuo-motor hyperexcitability.” The demonstration that this upregulation is detectable under resting (unstimulated) conditions and even during the alpha rhythm, the hallmark of the brain resting state, indicates a probable genetic predisposition to generate synchronous paroxysmal activity.

In PRM, neurophysiological investigations suggest that this myoclonic phenomenon requires the participation of both occipital and motor cortices. The excitatory activity elicited by the visual stimulus in the occipital cortex spread to the central motor cortex, generating a myoclonic volley that propagates down the spinal cord via fast-conducting corticospinal pathways.

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References

  1. Kasteleijn-Nolst Trenite DGA, Meletti S, Waltz S, Rubboli G. Photosensitivity and syndromes. In: Bureau M, Genton P, Dravet C, Guerrini R, Delgado-Escueta AV, Tassinari CA, Thomas P, Wolf P, editors. Epileptic syndromes in infancy, childhood and adolescence. 5th ed: John Libbey Eurotext Ltd; 2019. p. 431–47.

    Google Scholar 

  2. Kasteleijn-Nolst Trenité DGA, Binnie CD, Meinardi H. Photosensitive patients: symptoms and signs during intermittent photic stimulation and their relation to seizures in daily life. J Neurol Neurosurg Psychiatry. 1987;50:1546–9.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Guerrini R, Bonanni P, Parmeggiani L, et al. Induction of partial seizures by visual stimulation: clinical and electroencephalographic features and evoked potential studies. Adv Neurol. 1998;75:159–78.

    CAS  PubMed  Google Scholar 

  4. Isnard J, Guenot M, Fischer C, et al. A stereoelectroencephalographic (SEEG) study of light-induced mesiotemporal epileptic seizures. Epilepsia. 1998;39:1098–103.

    Article  CAS  PubMed  Google Scholar 

  5. Bickford RG, Sem-Jacobsen CW, White P, et al. Some observations on the mechanism of photoc and and photo-metrazol activation. Electroencephalogr Clin Neurophysiol. 1952;4:275–82.

    Article  CAS  PubMed  Google Scholar 

  6. Chatrian GE, Perez-Borja C. Depth electrographic observations in two cases of photo-osciloclonic response. Electroencephalogr Clin Neurophysiol. 1964;17:71–5.

    Article  CAS  PubMed  Google Scholar 

  7. Jeavons PM. Nosological problems of myoclonic epilepsies in childhood and adolescence. Dev Syndrom Med. 1977;19:3–8.

    CAS  Google Scholar 

  8. Striano S, Capovilla G, Sofia V, Romeo A, Rubboli G, Striano P, Trenité DK. Eyelid myoclonia with absences (Jeavons syndrome): a well-defined idiopathic generalized epilepsy syndrome or a spectrum of photosensitive conditions? Epilepsia. 2009;50(Suppl 5):15–9.

    Article  PubMed  Google Scholar 

  9. Bickford RG, Klass DW. Sensory precipitation and reflex mechanisms. In: Jasper HH, Ward AA, Pope A, editors. Basic mechanism of the epilepsies. Boston: Little Brown; 1969. p. 543–64.

    Google Scholar 

  10. Andermann F. Self-induced television epilepsy. Epilepsia. 1971;12:269–75.

    Article  CAS  PubMed  Google Scholar 

  11. Vignaendra V, Ghee LT, Lee LC, Tin CS. Epileptic discharges triggered by blinking and eye closure. Electroencephalogr Clin Neurophysiol. 1976;40:491–8.

    Article  CAS  PubMed  Google Scholar 

  12. Tassinari CA, Rubboli G, Rizzi R, Gardella E, Michelucci R. Self-induction of visually-induced seizures. Adv Neurol. 1998;75:179–92.

    CAS  PubMed  Google Scholar 

  13. Darby CE, de Korte RA, Binnie CD, Wilkins AJ. The self-induction of epileptic seizures by eye closure. Epilepsia. 1980;21(1):31–41.

    Article  CAS  PubMed  Google Scholar 

  14. Binnie CD, Darby CE, De Korte RA, Wilkins AJ. Self-induction of epileptic seizures by eye closure: incidence and recognition. J Neurol Neurosurg Psychiatry. 1980;43(5):386–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Newmark ME, Penry KJ. Photosensitivity and epilepsy: a review. New York: Raven; 1979.

    Google Scholar 

  16. Harding GFA, Jeavons PM. Photosensitive epilepsy. London: MacKeith Press; 1994.

    Google Scholar 

  17. Naquet R, Valin A. Experimental models of reflex epilepsy. Adv Neurol. 1998;75:15–28.

    CAS  PubMed  Google Scholar 

  18. Tassinari CA, Rubboli G, Michelucci R. Reflex epilepsy. In: Dam M, Gram L, editors. Comprehensive epileptology. New York: Raven Press; 1990. p. 233–46.

    Google Scholar 

  19. Grey Walter W, Dovey VJ, Shipton H. Analysis of the electrical response of the human cortex to photic stimulation. Nature. 1946;158:540–1.

    Article  Google Scholar 

  20. Shibasaki H, Neshige R. Photic cortical reflex myoclonus. Ann Neurol. 1987;22:252–7.

    Article  CAS  PubMed  Google Scholar 

  21. Artieda J, Obeso JA. The pathophvsiologv and pharmacology of photic cortical reflex myoclonus. Ann Neurol. 1993;34:175–84.

    Article  CAS  PubMed  Google Scholar 

  22. Rubboli G, Meletti S, Gardella E, Zaniboni A, d’Orsi G, Dravet C, Tassinari CA. Photic reflex myoclonus: a neurophysiological study in progressive myoclonus epilepsies. Epilepsia. 1999;40(Suppl 4):50–8.

    Article  PubMed  Google Scholar 

  23. Hennessy MJ, Binnie CD. Photogenic partial seizures. Epilepsia. 2000;41(1):59–64.

    Article  CAS  PubMed  Google Scholar 

  24. Naquet R, Fegersten L, Bert J. Seizure discharges localized to the posterior cerebral regions in man, provoked by intermittent photic stimulation. Electroencephalogr Clin Neurophysiol. 1960;12:305–16.

    Article  CAS  PubMed  Google Scholar 

  25. Aso K, Watanabe K, Negoroi T, Furune A, Takahashi I, Yamamoto N, Nomure K. Photosensitive partial seizures: the origin of abnormal discharges. J Epilepsy. 1988;1:87–93.

    Article  Google Scholar 

  26. Tassinari CA, Rubboli G, Plasmati R, Salvi F, Ambrosetto G, Bianchedi G, Forti A, Michelucci R. Television-induced epilepsy with occipital seizures: a variety of idiopathic partial occipital epilepsy. In: Beaumanoir A, Gastaut H, Naquet R, editors. Reflex seizures and reflex epilepsies. Geneva: Editions Medicines & Hygiene; 1988. p. 241–3.

    Google Scholar 

  27. Kasteleijn-Nolst Trenite DGA. Reflex seizures induced by intermittent light stimulation. Adv Neurol. 1998;75:99–121.

    CAS  PubMed  Google Scholar 

  28. Lefébre C, Kölmel HW. Palinopsia as an epileptic phenomenon. Eur Neurol. 1989;29:323–7.

    Article  PubMed  Google Scholar 

  29. Kataoka H, Ueno S. Cerebral polyopia and palinopsia in a patient with occipital lobe epilepsy. Epilepsy Behav. 2009;14:684–6.

    Article  PubMed  Google Scholar 

  30. Olivier A, Gloor P, Andermann F, Ives J. Occipitotemporal epilepsy studied with stereotaxically implanted depth electrodes and successfully treated by temporal resection. Ann Neurol. 1982;11:428–32.

    Article  CAS  PubMed  Google Scholar 

  31. Guerrini R, Ferrari AR, Battaglia A, Salvadori P, Bonanni P. Occipitotemporal seizures with ictus emeticus induced by intermittent photic stimulation. Neurology. 1994;44:253–9.

    Article  CAS  PubMed  Google Scholar 

  32. Genton P, Lavernhe G, Guerrini R. Epilepsie photogenique et phenomenes moteurs lateralises: une observation EEG. Epilepsies. 1995;7:431–5.

    Google Scholar 

  33. Duncan JS, Panayiotopoulos CP. The differentiation of “eye closure” from “eye closed” EEG abnormalities and their relation to photo- and fixation-off sensitivity. In: Duncan JS, Panayiotopoulos CP, editors. Eyelid myoclonia with absences. John Libbey & Company Ltd: London; 1996. p. 77–87.

    Google Scholar 

  34. Panayiotopoulos CP. Fixation-off, scotosensitive, and other visual-related epilepsies. In: Zifkin BG, Andermann F, et al., editors. Reflex epilepsies and reflex seizures: advances in neurology. New York: Lippincott-Raven; 1998. p. 139–55.

    Google Scholar 

  35. Sevgi EB, Saygi S, Ciger A. Eye closure sensitivity and epileptic syndromes: a retrospective study of 26 adult cases. Seizure. 2007;16:17–21.

    Article  PubMed  Google Scholar 

  36. Appleton RE, Panayiotopoulos CP, Acomb BA, Beirne M. Eyelid myoclonia with typical absences: an epilepsy syndrome. J Neurol Neurosurg Psychiatry. 1993;56:1312–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Giannakodimos S, Panayiotopoulos CP. Eyelid myoclonia with absences in adults: a clinical and video-EEG study. Epilepsia. 1996;37:36–44.

    Article  CAS  PubMed  Google Scholar 

  38. Striano S, Striano P, Nocerino C, et al. Eyelid myoclonia with absences: an overlooked epileptic syndrome? Neurophysiol Clin. 2002;32:287–96.

    Article  PubMed  Google Scholar 

  39. Covanis A. Jeavons syndrome. In: Panayiotopoulos CP, editor. Atlas of epilepsies. London: Springer; 2010. p. 1081–91.

    Chapter  Google Scholar 

  40. Caraballo RH, Fontana E, Darra F, et al. A study of 63 cases with eyelid myoclonia with or without absences: type of seizure or an epileptic syndrome? Seizure. 2009;18:440–5.

    Article  PubMed  Google Scholar 

  41. Fisher RS, Cross JH, French JA, Higurashi N, Hirsch E, Jansen FE, Lagae L, Moshé SL, Peltola J, Roulet Perez E, Scheffer IE, Zuberi SM. Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58:522–30.

    Article  PubMed  Google Scholar 

  42. Moeller F, Siebner HR, Ahlgrimm N, Wolff S, Muhle H, Granert O, Boor R, Jansen O, Gotman J, Stephani U, Siniatchkin M. fMRI activation during spike and wave discharges evoked by photic stimulation. NeuroImage. 2009;48:682–95.

    Article  PubMed  Google Scholar 

  43. Moeller F, Siebner HR, Wolff S, Muhle H, Granert O, Jansen O, Stephani U, Siniatchkin M. Mapping brain activity on the verge of a photically induced generalized tonic–clonic seizure. Epilepsia. 2009;50:1632–7.

    Article  PubMed  Google Scholar 

  44. Vaudano AE, Ruggieri A, Tondelli M, Avanzini P, Benuzzi F, Gessaroli G, Cantalupo G, Mastrangelo M, Vignoli A, Di Bonaventura C, Canevini MP, Dalla Bernardina B, Nichelli PF, Meletti S. The visual system in eyelid myoclonia with absences. Ann Neurol. 2014;76:412–27.

    Article  PubMed  Google Scholar 

  45. Parra J, Kalitzin SN, Iriarte J, Blanes W, Velis DN, Lopes da Silva FH. Gamma-band phase clustering and photosensitivity: is there an underlying mechanism common to photosensitive epilepsy and visual perception? Brain. 2003;2003(126):1164–72.

    Article  Google Scholar 

  46. Perry G, Brindley LM, Muthukumaraswamy SD, Singh KD, Hamandi K. Evidence for increased visual gamma responses in photosensitive epilepsy. Epilepsy Res. 2014;2014(108):1076–86.

    Article  Google Scholar 

  47. Vaudano AE, Ruggieri A, Avanzini P, Gessaroli G, Cantalupo G, Coppola A, Sisodiya SM, Meletti S. Photosensitive epilepsy is associated with reduced inhibition of alpha rhythm generating networks. Brain. 2017;140:981–97.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Menini C, Naquet R. Myoclonia. From the myoclonia of Papio papio to various human myoclonias. Rev Neurol (Paris). 1986;142:3–28.

    CAS  Google Scholar 

  49. Naquet R, Silva-Barrat C, Menini C. Reflex epilepsy in the Papio-papio baboon, particularly photosensitive epilepsy. Ital J Neurol Sci. 1995;16:119–25.

    Article  CAS  PubMed  Google Scholar 

  50. Naquet R, Meldrum BS. Myoclonus induced by intermittent light stimulation in the baboon: neurophysiological and neuropharmacological approaches. Adv Neurol. 1986;43:611–27.

    CAS  PubMed  Google Scholar 

  51. Menini C, Silva-Barrat C. The photosensitive epilepsy of the baboon: a model of generalized reflex epilepsy. Adv Neurol. 1998;75:29–47.

    CAS  PubMed  Google Scholar 

  52. Szabo CA, Narayana S, Kochunov PV, Franklin C, Knape K, Davis MD, et al. PET imaging in the photosensitive baboon: case-controlled study. Epilepsia. 2007;48:245–53.

    Article  PubMed  Google Scholar 

  53. Szabo CA, Salinas FS, Narayana S. Functional PET evaluation of the photosensitive baboon. Open Neuroimaging J. 2011;5:206–15.

    Article  Google Scholar 

  54. Szabo CA, Salinas FS. Voxel-based morphometry in epileptic baboons: parallels to human juvenile myoclonic epilepsy. Epilepsy Res. 2016;124:34–9.

    Article  PubMed  Google Scholar 

  55. Kanouchi T, Yokota T, Kamata T, Ishii K, Senda M. Central pathway of photic reflex myoclonus. J Neurol Neurosurg Psychiatry. 1997;62:414–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Brown P, Day BL, Rothwell JC, Thompson PD, Marsden CD. Intrahemispheric and interhemispheric spread of cerebral cortical myoclonic activity and its relevance to epilepsy. Brain. 1991;114:2333–51.

    Article  PubMed  Google Scholar 

  57. Pandya DN, Kuypers HGJM. Cortico-cortical connections in the rhesus monkey. Brain Res. 1969;13:13–36.

    Article  CAS  PubMed  Google Scholar 

  58. Haaxma R, Kuypers HGJM. Intrahemispheric cortical connections and visual guidance of hand and finger movements. Brain. 1975;98:239–60.

    Article  CAS  PubMed  Google Scholar 

  59. Charmasson G, Catier J. Etude electrophysiologicque des connexions occipito-frontales directes au niveau du centre ovale chez Papio papio. Electroencephalogr Clin Neurophysiol. 1975;38:161–70.

    Article  CAS  PubMed  Google Scholar 

  60. Wilkins A, Binnie C, Darby C, Kasteleijn-Nolst TrenitC DGA. Epileptic and non-epileptic sensitivity to light. In: Beaumanoir A, Gastaut H, Naquet R, editors. Reflex seizures and reflex epilepsies. Geneva: Editions Medecine & Hygiene; 1989. p. 153–62.

    Google Scholar 

  61. Valzania F, Strafella AP, Tropeani A, Rubboli G, Nassetti S, Tassinari CA. Facilitation of rhythmic events in progressive myoclonus epilepsy: a transcranial magnetic stimulation study. CIin Neurophysiol. 1999;1(10):152–7.

    Article  Google Scholar 

  62. Obeso JA, Artieda J, Tunon T, Luquin MR, Martinez Lage JM. Dopamine agonists suppress visual-cortex reflex myoclonus. J Neurol Neurosurg Psychiatry. 1985;48:1277–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Mervaala E, Andermann F, Quesney LF, Krelina M. Common dopaminergic mechanism for epileptic photosensitivity in progressive myoclonus epilepsies. Neurology. 1990;40:53–6.

    Article  CAS  PubMed  Google Scholar 

  64. Manganotti P, Bongiovanni LG, Zanette G, Fiaschi A. Early and late intracortical inhibition in juvenile myoclonic epilepsy. Epilepsia. 2000;41:1129–38.

    Article  CAS  PubMed  Google Scholar 

  65. Badawy R, Macdonell R, Jackson GD, Berkovic SF. Can changes in cortical excitability distinguish progressive from juvenile myoclonic epilepsy? Epilepsia. 2010;51:2084–8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Danish Epilepsy Center, Filadelfia, Dianalund, Denmark

    Guido Rubboli & Elena Gardella

  2. University of Copenhagen, Copenhagen, Denmark

    Guido Rubboli

  3. University of Southern Denmark, Odense, Denmark

    Elena Gardella

  4. Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy

    Stefano Meletti

  5. Neurology Department, Azienda Ospedaliera-Universitaria, Modena, Italy

    Stefano Meletti

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  1. Guido Rubboli
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  2. Elena Gardella
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  3. Stefano Meletti
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Correspondence to Guido Rubboli .

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Editors and Affiliations

  1. Department of Neurosurgery and Epilepsy, University Medical Center Utrecht, Utrecht, The Netherlands

    Dorothee Kasteleijn-Nolst Trenite

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Rubboli, G., Gardella, E., Meletti, S. (2021). Motor Manifestations in Epileptic Photosensitivity: Clinical Features and Pathophysiological Insights. In: Kasteleijn-Nolst Trenite, D. (eds) The Importance of Photosensitivity for Epilepsy. Springer, Cham. https://doi.org/10.1007/978-3-319-05080-5_15

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  • DOI: https://doi.org/10.1007/978-3-319-05080-5_15

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