Jeavons Syndrome Presenting with Ictal Eructation
Abstract number :
3.247
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2024
Submission ID :
162
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Amirtha Shekar, BS – University of Texas Health sciences San Antonio
Sreekanth Koneru, MD – University of Texas Health sciences Sanantonio/South Texas Comprehensive Epilepsy Center
Charles Szabo, MD – UT Health San Antonio/South Texas Comprehensive Epilepsy Center
Rationale: Jeavons Syndrome is a rare type of absence seizure with eyelid myoclonia. Patients are often diagnosed between ages 1-15 years old and the condition is characterized by the presence of eyelid fluttering, and eyelid-closure or bright light induced seizures. Remission occurs in less than 50% of patients. While this is the typical course of Jeavons syndrome, we present a patient presenting with ictal belching. Ictal eructation, or belching, is typically associated with non-epileptic disorders, but has been reported in people with focal epilepsy.
Refrences:
Stoyan Popkirov,Wenke Gronheit, Jorg Wellmer Epilepsy and Behavior case reports 5(2016)11-12
Ifrah Zawar, MD, Elia Pestana Knight,MD Pediatric Neurology 121(2021)75-80
Methods: We present a 57-year old right-handed female with a history of absence epilepsy since age two years old as well as moderate mental retardation with behavioral dyscontrol. She was seizure free for many years on ethosuximide, but her seizures recurred as her dose was decreased. After raising her dose , she also began to experience falls, at times with loss of awareness. She was admitted for inpatient video-EEG monitoring at University Hospital in San Antonio, Texas, for characterization of falls at an ethosuximide dose of 250mg daily and clonazepam 1mg nightly for four days.
Results: The video-EEG study confirmed the diagnosis of generalized epilepsy, the patient was demonstrating 3-6 absence seizures per hour while awake. In addition to decreased responsiveness, her absence seizures were associated at times with belching followed by eyelid myoclonia with subtle oral mouth movements lasting for 3-4 seconds. Her belching was correlated with an ictal discharge , consisting of a 3-6 Hz generalized spike- and polyspike-and-wave discharges. Belching was not noted in the absence of an ictal discharge. The falls were not associated with ictal EEG correlate.
Conclusions: Our patient demonstrates ictal belching followed by eyelid myoclonia that are correlated with generalized ictal discharges on EEG. To our Knowledge, this is the first reported case of ictal eructation or belching associated with a generalized epilepsy.
Funding: none
Neurophysiology