Re: Eyelids Fluttering - Eyelid myoclonia with absences: routine EEG is sufficie

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Seizure. 2007 Apr;16(3):254-60.

Eyelid myoclonia with absences: routine EEG is sufficient to make a

diagnosis.

Joshi CN, J.

Section of Pediatric Neurology, Department of Pediatrics, Children's

Hospital, AE 108 Harry Medovy House, 820 Sherbrook Street, Winnipeg,

MB R3A1S1, Canada.

PURPOSE: To identify the prevalence, clinical characteristics and

routine EEG features of the syndrome of eyelid myoclonia with

absences (EMA) using a retrospective case control study design.

METHODS: EEGs from 1996 to 2005 were searched using the following

keywords: eyelid flutter, eyelid blinking, tics, idiopathic

generalized epilepsy, clinical absence, atypical absence and

photoparoxysmal response. During the same period, patients with a

diagnosis of idiopathic generalized epilepsy were identified.

Patients with mainly eyelid fluttering/eyelid blinking as their

seizure semiology were divided into EMA and non-EMA groups using

previously published criteria and compared using parametric

(Student's t-test) and non-parametric tests (Chi square) where

appropriate. A p-value of <0.05 was considered significant.

RESULTS: The keywords identified 997 patients, 288 patients were

diagnosed with idiopathic generalized epilepsy; 126 had eyelid

fluttering/blinking as their major seizure semiology. After

excluding 51 patients due to incomplete data, of 75 remaining

patients, 26 (9.03%) had EMA. Patients with EMA were (1) older at

time of first EEG (OR=2.86; 95% CI=7.00-10.23; p=0.005) (2) more

likely to have an event on routine EEG (OR=3.62; 95% CI=1.28-10.19;

p=0.01) (3) had >3 events per day (OR=9.73; 95% CI=2.06-45.96;

p=0.0012) (4) had higher prevalence of developmental delay (OR=4.46;

95% CI=1.36-14.67; p=0.01) and (5) had normal EEG background

compared to the non-EMA group.

CONCLUSION: EMA is not uncommon; diagnosis can be made with good

clinical history and routine EEG. As developmental delay is a common

association with EMA in this study, early identification and

treatment are important.