Pattern-sensitive epileptic patients use uncomfortable visual stimuli to self-induce seizures

Sensory stimuli can induce seizures in epileptic patients and predisposed subjects. Visual stimuli are the most common triggers, provoking seizures through an abnormal response to light or pattern. Sensitive patients may intentionally provoke their seizures through visual stimuli. Self-induction methods are widely described in photo-sensitive patients, while there are only a few reports of those who are pattern-sensitive. We analysed 73 images of environmental visual triggers collected from 14 pattern-sensitive patients with self-induced seizures. The images were categorized according to their topics: 29 Objects (43%); 19 Patterns (28%); 15 External scenes (22%); 4 TV or computer screens (6%). Six photos were of poor quality and were excluded from analysis. Images were analysed by an algorithm that calculated the degree to which the Fourier amplitude spectrum differed from that in images from nature. The algorithm has been shown to predict discomfort in normal observers. The algorithm identified thirty-one images (46%) as “uncomfortable”. There were significant differences between groups of images (ANOVA p

[1]  M. Brinciotti,et al.  Optimizing the Patient’s History: A Modern Approach , 2020, The Importance of Photosensitivity for Epilepsy.

[2]  E. Thiele,et al.  Sunflower syndrome: a poorly understood photosensitive epilepsy , 2020, Developmental medicine and child neurology.

[3]  E. Thiele,et al.  Characterizing Sunflower syndrome: a clinical series. , 2020, Epileptic disorders : international epilepsy journal with videotape.

[4]  M. Brinciotti,et al.  Characteristics of visual evoked potentials related to the electro-clinical expression of reflex seizures in photosensitive patients with idiopathic occipital lobe epilepsy , 2020, Epilepsy Research.

[5]  B. Porter,et al.  Clinical and electrographic features of sunflower syndrome , 2018, Epilepsy Research.

[6]  Olivier Penacchio,et al.  Discomfort from urban scenes : metabolic consequences , 2017 .

[7]  F. Thibaut.  The role of sex and gender in neuropsychiatric disorders , 2016, Dialogues in clinical neuroscience.

[8]  Michael Bach,et al.  ISCEV standard for clinical visual evoked potentials: (2016 update) , 2016, Documenta Ophthalmologica.

[9]  P. Striano,et al.  Genetics of reflex seizures and epilepsies in humans and animals , 2016, Epilepsy Research.

[10]  K. Lehnertz,et al.  Reflex seizures, traits, and epilepsies: from physiology to pathology , 2016, The Lancet Neurology.

[11]  C. Epperson,et al.  Sex differences and stress across the lifespan , 2015, Nature Neuroscience.

[12]  Olivier Penacchio,et al.  Visual discomfort and the spatial distribution of Fourier energy , 2015, Vision Research.

[13]  P. Striano,et al.  Self-induction seizures in sunflower epilepsy: a video-EEG report. , 2014, Epileptic disorders : international epilepsy journal with videotape.

[14]  A. Wilkins,et al.  Cortical hyperexcitability in migraine and aversion to patterns , 2012, Cephalalgia : an international journal of headache.

[15]  Edouard Hirsch,et al.  Methodology of photic stimulation revisited: Updated European algorithm for visual stimulation in the EEG laboratory , 2012, Epilepsia.

[16]  J. H. Cross,et al.  Revised terminology and concepts for organization of seizures and epilepsies: Report of the ILAE Commission on Classification and Terminology, 2005–2009 , 2010, Epilepsia.

[17]  A. Wilkins,et al.  Uncomfortable Images in Art and Nature , 2008, Perception.

[18]  M. Brinciotti,et al.  Long‐Term Outcome of Pattern‐Sensitive Epilepsy , 2006, Epilepsia.

[19]  D. Trenité,et al.  Photosensitivity, visually sensitive seizures and epilepsies , 2006, Epilepsy Research.

[20]  A. Wilkins,et al.  Photic‐ and Pattern‐induced Seizures: A Review for the Epilepsy Foundation of America Working Group , 2005, Epilepsia.

[21]  Arnold Wilkins,et al.  Characterizing the Patterned Images That Precipitate Seizures and Optimizing Guidelines To Prevent Them , 2005, Epilepsia.

[22]  P. Huppke,et al.  Visually Self‐induced Seizures Sensitive to Round Objects , 2005, Epilepsia.

[23]  E. K. Louis,et al.  Pattern‐sensitive Epilepsy: Electroclinical Characteristics, Natural History, and Delineation of the Epileptic Syndrome , 2005, Epilepsia.

[24]  D. Bansal,et al.  Self induced photosensitive epilepsy , 2004, Indian journal of pediatrics.

[25]  K. Radhakrishnan,et al.  Half a century of visual pattern-sensitive epilepsy. , 2004, Mayo Clinic proceedings.

[26]  D. Pinto,et al.  Genetics of Photosensitivity (Photoparoxysmal Response): A Review , 2004, Epilepsia.

[27]  E. Brodtkorb,et al.  Partial epilepsy with “ecstatic” seizures , 2003, Epilepsy & Behavior.

[28]  B. Ng.  Psychiatric Aspects of Self-Induced Epileptic Seizures , 2002, The Australian and New Zealand journal of psychiatry.

[29]  A. Pelliccia,et al.  Pattern Sensitivity and Photosensitivity in Epileptic Children with Visually Induced Seizures , 1994, Epilepsia.

[30]  M. Brinciotti,et al.  Self‐Induced Pattern‐Sensitive Epilepsy in Childhood , 1990, Acta paediatrica Scandinavica.

[31]  T. Kurashige,et al.  Proposal for Revised Classification of Epilepsies and Epileptic Syndromes , 1989, No to hattatsu = Brain and development.

[32]  F. Dreifuss,et al.  Self-induced photosensitive absence seizures with ictal pleasure. , 1986, Archives of neurology.

[33]  A. Wilkins,et al.  Mechanisms of epileptogenesis in photosensitive epilepsy implied by the effects of moving patterns. , 1985, Electroencephalography and clinical neurophysiology.

[34]  A. Wilkins,et al.  A neurological basis for visual discomfort. , 1984, Brain : a journal of neurology.

[35]  A. Wilkins,et al.  The Self‐induction of Epileptic Seizures by Eye Closure , 1980, Epilepsia.

[36]  R. Henson,et al.  Pattern sensitive epilepsy: a case report , 1979, Journal of neurology, neurosurgery, and psychiatry.

[37]  F. Andermann,et al.  Self-Induced Television Epilepsy: A Study of two Patients * , 1976, Canadian Psychiatric Association journal.

[38]  J. Hutchison,et al.  Photogenic epilepsy induced by the patient. , 1958, Lancet.

[39]  D. Creel,et al.  Visually evoked potentials. , 2019, Handbook of clinical neurology.

[40]  J. Engel,et al.  ILAE Official Report: A practical clinical definition of epilepsy , 2014, Epilepsia.

[41]  M. Davoli,et al.  Declarations of interest None. , 2008 .

[42]  R. Michelucci,et al.  Self-induction of visually-induced seizures. , 1998, Advances in neurology.

[43]  C. Panayiotopoulos.  Self-induced pattern-sensitive epilepsy. , 1979, Archives of neurology.