The Reflex Epilepsies

The term reflex epilepsy is used to describe cases in which seizures are evoked consistently by a specific environmental trigger. In some cases the stimulus can be highly specific and in others less so. The term is not usually applied to patients whose seizures are precipitated by internal influences such as menstruation, nor to situations where the precipitating factors are vague or ill-defined (e.g. fatigue, stress), nor to patients with existing epilepsy where seizures are more likely to occur owing to specific precipitants (e.g. sleep deprivation, alcohol); transitional cases, however, occur in what can be a nosological grey area. The reflex epilepsies are sometimes subdivided into simple and complex types. In the simple forms the seizures are precipitated by simple sensory stimuli (e.g. flashes of light, startle) and in the complex forms by more elaborate stimuli (e.g. specific pieces of music). The complex forms are much more heterogeneous and the syndromes are less well defined than the simple reflex epilepsies. In hospital practice about 5% of patients show some features of reflex epilepsy. The stimuli most reported to cause seizures include flashing lights and other visual stimuli, startle, eating, bathing in hot water, music, reading, and movement.

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