Abstract Details

Title Photosensitive Epilepsy: Report of Rare Sunflower Syndrome Characterization

Topic Child Neurology and Developmental Neurology

Presentation(s) P2 - Poster Session 2 (8:00 AM-9:00 AM)

Poster/Presentation
Number 6-008

Objective NA

Background

Sunflower syndrome is a rare photosensitive epilepsy syndrome characterized by stereotyped seizures, photosensitivity, and heliotropism.

Design/Methods We describe a 10-year-old boy with normal development, and diagnoses of ADHD and tic disorder, who presented for a second opinion after generalized tonic clonic seizures (GTCs). He had a non-focal neurological physical exam. Mother reported repetitive arm waving in front of his face and eye fluttering that preceded GTCs.

Results Routine blood work and brain MRI were normal. Video electroencephalogram (EEG) revealed interictal polyspike discharges, and a photoparoxsymal response. Our patient’s hand-waving episodes and seizures responded almost completely to valproic acid and other non-pharmacological measures (sunglasses).

Conclusions Sunflower Syndrome is an under-recognized, typically refractory, photosensitive epilepsy syndrome characterized by compulsive hand-waving in front of the face to mimic a strobe effect. Patients are often drawn to light sources (sunlight, bright lights) that will induce the epileptic seizure, eyelid myoclonia and hand-waving episodes. Although there are several reports of Sunflower syndrome in the medical literature, this epilepsy continues to be poorly understood. There continues to be uncertainty regarding whether the hand-waving episodes themselves are ictal in nature. We describe in this case report electrographic ictal correlation with the hand-waving episodes. This is consistent with other studies that have presented EEG data that supports the hypothesis that the hand-waving episodes are in fact part of the seizure semiology. In this case the patient was able to be treated and had good clinical and electrographic response to mono-therapy with valproic acid.

Authors/Disclosures
Jasmine Policherla, DO (Children's Hospital Of Michigan) PRESENTER	Dr. Policherla has nothing to disclose.

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