Stichting Epilepsie Instellingen Nederland (SEIN), Hoofddorp, The Netherlands.
University Medical Center Utrecht, Utrecht, The Netherlands.
Epileptic Disord. 2024 Jun;26(3):293-301. doi: 10.1002/epd2.20209. Epub 2024 Mar 18.
Photosensitivity is known to occur predominantly in children and adolescents and with a clear female predominance. Little is known on the prevalence of photosensitivity in older patients (50+) and its phenotypical appearance.
A retrospective observational study was performed investigating the prevalence of a photoparoxysmal EEG response (PPR) on at least one EEG during the period 2015-2021. Data were gathered from patients aged 50 years and older by retrieving clinical and EEG characteristics from existing medical records. Data on photosensitivity-related symptoms in daily life were gathered with telephone interviewing.
In 248 patients a PPR had been elicited, of whom 16 patients (6.5%) were 50 years or older. In older patients, photosensitivity was a persistent feature of childhood-onset epilepsy (n = 8), of adult-onset epilepsy (n = 7), or an incidental finding (n = 1). In the 50+ group, 56% of photosensitive patients was female, whereas 72% in the total PPR-group. In six of 16 older patients, eye closure sensitivity was observed; two of these patients reported self-induction. Symptoms of photosensitivity in daily life were present in eight out of nine patients who consented in a telephone interview. For seven of these patients, wearing sunglasses was helpful.
Female preponderance for photosensitivity was not found in epilepsy patients of 50 years and older. In 44% of the older photosensitive patients in this series, the PPR was a feature of adult-onset epilepsy. Symptoms of photosensitivity in daily life in older patients with epilepsy seem comparable to those in younger patients, and thus worthwhile to diagnose and treat them equally.
光敏感性已知主要发生在儿童和青少年中，且女性明显居多。对于 50 岁以上的老年患者中光敏感性的患病率及其表型表现，人们知之甚少。
本研究通过检索现有病历中的临床和脑电图特征，开展了一项回顾性观察性研究，以调查 2015 年至 2021 年期间至少有一次脑电图出现光阵发性脑电图反应（PPR）的患者比例。研究对象为年龄在 50 岁及以上的患者。通过电话访谈收集患者日常生活中与光敏感性相关的症状数据。
在 248 名患者中诱发了 PPR，其中 16 名（6.5%）患者年龄在 50 岁及以上。在老年患者中，光敏感性是儿童期起病癫痫（n=8）、成年期起病癫痫（n=7）或偶发表现（n=1）的持续特征。在 50 岁以上的患者中，56%的光敏感性患者为女性，而在总 PPR 组中为 72%。在 16 名老年患者中，有 6 名观察到闭眼敏感性，其中 2 名患者报告可以自我诱导。在电话访谈中，同意参与的 9 名患者中有 8 名存在日常生活中的光敏感性症状。对于这 7 名患者中的 7 名，戴太阳镜有帮助。
在 50 岁及以上的癫痫患者中，光敏感性不存在女性优势。在本研究系列中，44%的老年光敏感性患者的 PPR 是成年期起病癫痫的特征。老年癫痫患者日常生活中的光敏感性症状与年轻患者相似，因此值得同等诊断和治疗。
