Electrographic Seizures in a Blind Patient: Do They Imply a Diagnosis of Epilepsy?
Abstract number :
2.23
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2024
Submission ID :
378
Source :
www.aesnet.org
Presentation date :
12/8/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Yensea Costas Encarnacion, MD – University of Miami - Jackson Memorial Hospital
Maya Gabel, MD – University of Miami - Jackson Memorial Hospital
Andres Kanner, MD – Miller School of Medicine, University of Miami
Rationale:
Patients with early or congenital blindness have been reported to have interictal epileptiform discharges in occipital regions, which have been interpreted as non-pathological variants, as no clinical seizures were identified. However, electrographic seizures without clinical phenomena have not been reported as non-pathologic variants in blind patients. We present a case of Leber’s Congenital Amaurosis (LCA) who’s EEG recordings revealed frequent recurrent electrographic seizures without any concordant clinical phenomena.
Methods: Case Report
Results:
A 36-year-old right-handed female with a history of LCA (type 7 – CRX gene mutation: c.650del) and subsequent significant visual impairment since early childhood presented for neurologic evaluation following a convulsive syncope. She underwent an EEG study which was interpreted as recurrent electrographic seizures and focal slowing in the right posterior temporal-occipital region without any clinical correlation. She was started on levetiracetam up to a dose of 1500 mg /day without remission of these seizures, as demonstrated in a 24-hour video-EEG study that revealed rare right basotemporal occipital sharp and slow wave discharges as well as multiple focal electrographical seizures (see figure 1) without any concurrent clinical phenomena. High-resolution brain MRI brain with and without intravenous contrast and Brain PET scan were unremarkable. Neuropsychological testing did not reveal any deficits.
Conclusions:
To the best of our knowledge, this is the first report of very frequent electrographical seizures without any clinical phenomena in a patient with LCA. Given that, interictal epileptiform discharges have been reported in patients with blindness without clinical evidence of epilepsy, the findings identified in our patient may be a different electrographic expression of epileptiform activity in blind patients that have no clinical significance. Therefore, these patients do not need to be treated with antiseizure medications.
Funding: No funding received for this abstract.
Clinical Epilepsy