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Epileptic Disorders

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Eyelid myoclonia with absences related to epileptic negative myoclonus Volume 23, issue 6, December 2021

Figure 1

Ictal video-EEG depicting an eye closure-induced seizure (the timing of the images of eyelid movement on the right are indicated by number within the trace on the left). After eye closure, incidental eye opening (image 2 and 3) was associated with diffuse polyspikes and waves with a predominance in the occipital area.

Figure 2

Ictal EEG depicting an eye closure-induced seizure. (A) After eye closure, eyelid fluttering appeared to be coincident with 3.0-4.5-Hz diffuse polyspike-and-wave complexes on EEG. Massive myoclonus was observed with a rosto-caudal pattern (in the order of trapezius, deltoid and forearm), with latencies of propagation, and the finding revealed cortical myoclonus. Atonia on the mentalis muscle was also noted. Low-frequency filter: 1.6 Hz; high-frequency filter: 60 Hz; notch filter: on. (B) Importantly, EEG and EMG at 6 cm/second showing tonic contraction of the orbicularis oculi muscle interrupted by three successive brief periods of decreased tonus (indicated by thick black lines) lasting for 60∼140 mseconds, each of which was coincident with spike component of spike-waves on EEG, consistent with ENM.