Reading epilepsy in a patient with previous idiopathic focal epilepsy with centre-temporal spikes (BECT)

Abstract

Objective Reading epilepsy (RE) is a form of reflex epilepsy classified as an idiopathic localization-related epilepsy (ILAE, 1989). Methods and results We describe a 30-year-old right-handed male who has had nocturnal partial motor seizures since age 8 years. Clinical features were typical of BECT. We reviewed the EEG recorded at that time which showed centre-temporal spike and waves. He was seizure-free from the age of 12 to the age of 17 years when seizures evoked only by reading appeared. No other stimuli were effective in provoking seizures. Neurological and neuroradiological (CT and MRI) investigations were normal. Baseline video-polygraphic EEG recordings were normal, while reading aloud provoked myoclonic jerks in the facial muscles related to bilateral spike and wave discharges. Therapy with carbamazepine and valproic acid strongly reduced seizure frequency. Conclusions Recent papers have debated the difficulties in classifying RE among the generalized or focal syndromes. Literature reports describe an association with RE and juvenile myoclonic epilepsy, supporting the hypothesis of an idiopathic generalized form. We report the first documented case with a clear-cut idiopathic localization-related epilepsy evolving to a primary reading epilepsy.