ICNC Abstracts, ICNC 2018

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Not all that blinks is tics
Samata Singhi

Last modified: 2018-09-09

Abstract


INTRODUCTION: We present the case of a girl who had eye rolling and blinking episodes diagnosed as tics, which worsened over time. A diagnosis of Jeavon’s syndrome was made after long term EEG monitoring.

CASE DESCRIPTION: A 14-year-old girl presented with episodes of stereotyped eye fluttering and eye rolling with neck extension and no alteration of awareness, occurring since five years of age. The episodes worsened with anxiety, fatigue, or excitement , were reportedly suppressible and were being treated as tics. Recently she experienced worsening of symptoms in sunlight wherein she had eyelid fluttering and difficulty understanding commands. A routine EEG showed spikes, polyspikes, sharp waves and spike-and-slow-wave complexes in the frontal, central and posterior head regions bilaterally. In the epilepsy monitoring unit, several episodes were captured; EEG showed bilateral spike/ polyspike and wave complexes within 0.5 seconds of the onset of eye flutter. With photic stimulation, several runs of diffuse spike/ polyspike and wave discharges evolving to rhythmic alpha activity and then slowing down were noted. A diagnosis of Jeavon’s syndrome was made and Lamotrigine was started.

CONCLUSION: Jaevon’s syndrome is characterized by (1) eyelid myoclonia with /without absences; (2) eye closure-induced seizures and EEG paroxysms; and (3) photosensitivity. Eyelid myoclonia is often misdiagnosed as facial tics. This case highlights the importance of keeping Jeavon’s syndrome in the differential of eyelid flutter and the role of video EEG in diagnosis. If untreated, patients remain at risk for generalized tonic clonic seizures.


Keywords


Jaevon's

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