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Photosensitivity and Epilepsy

  • Dorothee Kasteleijn-Nolst TreniteEmail author
Chapter

Abstract

Intermittent photic stimulation (IPS) is a routine provocation method with stroboscopic light flashing between 2 and 60 Hz to diagnose epilepsy—or the genetic trait—and to evaluate (non)pharmacological treatment. Eye closure at the onset of the IPS stimulus train is the most provocative: one would miss a diagnosis of photosensitivity in 10% of patients, if only eyes closed and open is performed. The choice of photostimulator is of great importance too. Especially in children IPS is helpful in diagnosing encephalopathies like Dravet syndrome at an early stage. Even when there are already spontaneous epileptiform discharges, IPS gives information: is it provoking or suppressing the discharges and at what eye conditions—is there self-induction, for example, or fixation off? After some historical background, important issues are being discussed and examples given.

Overall, photic stimulation (and stimulation with other visual stimuli like striped black-and-white patterns and computer games) needs to be done with great care to get the maximum of information needed without making it too uncomfortable for the patient, let alone provoking GTCS. Advice on how to perform photic stimulation with underlying evidence can be found in the EU guidelines from 2012 (see ILAE website: guidelines for diagnosis or at PubMed Ref # 11).

Keywords

Photoparoxysmal PPR Photosensitivity Encephalopathies EEG 

Notes

Acknowledgement

Conflict of Interest: none.

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Neurosurgery and EpilepsyUniversity Medical Center UtrechtUtrechtThe Netherlands
  2. 2.Faculty of Medicine and Psychology, Nesmos DepartmentSapienza UniversityRomeItaly

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