da Conceição Priscila Oliveira, Guaranha Mirian Salvadori Bittar, Uchida Carina Gonçalves Pedroso, Carvalho Kelly, Guilhoto Laura M F F, De Araújo-Filho Gerardo M, Júnior Henrique Carrete, Wolf Peter, Yacubian Elza Márcia Targas
Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Seizure. 2015 Jan;24:12-6. doi: 10.1016/j.seizure.2014.10.011. Epub 2014 Nov 18.
Eyelid myoclonia (EM) is considered a seizure type and has been described in several epileptic conditions. Previous studies reported that EM are precipitated only by slow eye closure, but little is known about the characteristics of blinking in patients with EM seizures and differences in precipitation of EM by different kinds of eye closure. We analyzed by video-EEG the characteristics of blinking and eye closure in these patients.
Twenty patients with EM had a video-EEG protocol with eyelid sensors. Semiology and rate of blinking and EM were analyzed. Statistical analysis was performed and p-values <0.05 were considered significant.
Seventeen cases (mean age 20.7, range 3-35) were women, 10 had EM as the main seizure type and between the others, all, but one, had criteria to Juvenile Myoclonic Epilepsy. All patients presented EM, 18 spontaneously during awake, 10 on eye closure and one only during intermittent photic stimulation. EM assumed the form of flicker, flutter or jerk, accompanied by generalized discharges, spiky posterior alpha, theta rhythm or absence of any EEG abnormality. Analysis of the characteristics of blinking had no statistics differences between patients and healthy subjects. The rate of blinks and EM increased during speech and decreased during reading. EM never occurred during blinking or in the dark.
Despite normal physiology of blinking, EM can manifest as jerk, flicker or flutter, with or without EEG abnormalities and independently of IPS, suggesting that eye closure sensitivity seems to include both, a motor and a visual component.
眼睑肌阵挛（EM）被认为是一种癫痫发作类型，已在多种癫痫病症中有所描述。既往研究报道EM仅由缓慢闭眼诱发，但对于EM发作患者眨眼的特征以及不同类型闭眼诱发EM的差异知之甚少。我们通过视频脑电图分析了这些患者眨眼和闭眼的特征。
20例EM患者进行了带有眼睑传感器的视频脑电图检查。分析了症状学以及眨眼和EM的发生率。进行了统计学分析，p值<0.05被认为具有显著性。
17例（平均年龄20.7岁，范围3 - 35岁）为女性，10例以EM为主要发作类型，其他患者中，除1例之外，均符合青少年肌阵挛癫痫的标准。所有患者均出现EM，18例在清醒时自发出现，10例在闭眼时出现，1例仅在间歇性光刺激时出现。EM表现为闪烁、扑动或抽搐，伴有全身性放电、尖波后α波、θ节律或无任何脑电图异常。眨眼特征分析显示患者与健康受试者之间无统计学差异。眨眼和EM的发生率在说话时增加，在阅读时降低。EM从未在眨眼时或黑暗中出现。
尽管眨眼生理功能正常，但EM可表现为抽搐、闪烁或扑动，伴有或不伴有脑电图异常，且与间歇性光刺激无关，这表明闭眼敏感性似乎包括运动和视觉成分。
