Self-induction of epileptic seizures by eye closure: Incidence and recognition

Abstract

Self-induction of epileptic seizures is generally regarded as a rarity, chiefly observed in patients of subnormal intelligence. During EEG recordings with open eyes in a consecutive series of 48 photosensitive patients, however, 13 subjects induced paroxysmal activity or seizures by eye closure with forced upward deviation of the eyes. Eye closure on command produced a different type of oculographic artefact and induced paroxysmal activity in only one subject. Two patients were of subnormal intelligence but all displayed psychiatric or psychosocial problems. The incidence of induced paroxysmal activity was reduced by reduction of ambient lighting. Eight patients admitted self-induction of seizures. The authors conclude that this phenomenon occurs more often than was previously supposed and can be recognized by the recording in photosensitive patients of prolonged EEGs with eyes open and in a brightly lit environment.