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Drawing-induced epilepsy reported

EpilepsyMar 24, 06

Artists beware. In the journal Neurology this month, doctors report a case of reflex epilepsy triggered by the experience of drawing.

At presentation, the 19-year-old student had experienced short-lasting twitches in both arms shortly before losing consciousness and exhibiting seizure-type activity for two minutes. He was working on a drawing assignment at the time symptoms began.

The patient reported previous episodes of twitching of the arms and “special sensations” while drawing but not while engaged in any other activities.

Brain imaging studies were normal and showed “left hemispheric dominance” consistent with the boy being left-handed, report Dr. Kuan H. Kho and associates at the University Medical Center Utrecht, the Netherlands.

However, an electroencephalogram or EEG, which measures brain activity, conducted while the patient drew, showed spike and wave discharges in the right front and back lobes, coinciding with spasms of the arms, disorientation and an inability to resume drawing for up to 30 seconds.

Other types of stimulation outside of drawing—such as looking at pictures and writing—did not produce activity on EEG or any seizure-type symptoms.

“The mechanisms underlying reflex epilepsies remain uncertain,” Dr. Bruce L. Miller of the University of California at San Francisco points out in an accompanying editorial.

“The dissociation between writing (a more common trigger for reflex epilepsy) and drawing emphasizes the presence of anatomically distinctive cognitive modules in the dominant and nondominant hemispheres.”

SOURCE: Neurology March 2006.



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