Covanis Athanasios
Neurology Department, The Children Hospital Agia Sophia, Athens, Greece.
Epilepsia. 2005;46 Suppl 9:67-72. doi: 10.1111/j.1528-1167.2005.00315.x.
Photosensitivity is an abnormal visual sensitivity of the brain in reaction to flickering light sources or patterns and is expressed in the electroencephalogram as generalized spike-and-wave discharge and in more susceptible individuals as clinical seizures. The most common types of seizures are generalized tonic-clonic, followed by myoclonic and absence. The photosensitive epilepsies are classified as pure photosensitive, where seizures occur only with the flickering light source/pattern or during intermittent photic stimulation (IPS) in the laboratory, and epilepsy with photosensitivity, where spontaneous seizures also occur. Positive response to IPS in idiopathic epilepsy syndromes, which are included in the International Classification or are in development, is reported to range from 7.5% in juvenile absence epilepsy to 100% in pure photosensitive epilepsy. The treatment of photosensitivity and pure photosensitive epilepsy with rare seizures includes general and specific protective measures. For most patients, however, combination treatment with antiepileptic drugs is necessary. Valproic acid monotherapy has a success rate of 73-86%. Levetiracetam appears to be a new alternative therapeutic option. Clobazam, lamotrigine, ethosuximide, and topiramate also have been recommended as second-choice therapies.
光敏性是大脑对闪烁光源或图案的一种异常视觉敏感性，在脑电图中表现为广泛性棘波和慢波放电，在更易患个体中则表现为临床癫痫发作。最常见的癫痫发作类型是全身性强直阵挛发作，其次是肌阵挛发作和失神发作。光敏性癫痫分为纯光敏性癫痫，即癫痫发作仅在闪烁光源/图案出现时或在实验室的间歇性光刺激（IPS）期间发生；以及伴有光敏性的癫痫，即也会出现自发性癫痫发作。据报道，在国际分类中或正在制定的特发性癫痫综合征中，对IPS的阳性反应范围从青少年失神癫痫的7.5%到纯光敏性癫痫的100%。对于光敏性和发作罕见的纯光敏性癫痫的治疗，包括一般和特定的保护措施。然而，对大多数患者而言，抗癫痫药物联合治疗是必要的。丙戊酸单药治疗的成功率为73 - 86%。左乙拉西坦似乎是一种新的替代治疗选择。氯巴占、拉莫三嗪、乙琥胺和托吡酯也被推荐作为二线治疗药物。
