Table 1.
Type of reflex epilepsy | Sex, prevalence | Genetics | Identified loci or genes | Seizure type | Epileptic syndromes or associated conditions | Prognosis | Treatment |
---|---|---|---|---|---|---|---|
Photosensitivity | 1/4,000 (2%–10% of PWE) female > male (60%) | Likely autosomal dominant with reduced penetrance, independent from seizures disorder | 6p21, 7q32, 13q31, 16p13 | – Absence, myoclonia – GTCS – Focal (mainly occipital) |
– GGE (especially JME) – IPOE – PME – DS Rarely with acquired lesions |
Usually favorable response, may remit in 25% after age 30 years | Preventive measures (stimulus avoidance, lens, etc.) VPA first choice, LTG and LEV as the second choice |
Musicogenic epilepsy | 1:10,000,000 | Usually none reported in patients with ADTLE | LGI1/Epitempin SCN1A | Usually temporal lobe seizures | Epilepsies with epileptogenic lesions also in patients with ADTLE | Variable, usually refractory | Stimulus avoidance Medication for focal seizures |
Reading epilepsy | Rare, male/female: 1.8/1 | Autosomal dominant inheritance with incomplete penetrance | None | Jaw jerks that may progress to GTCS if reading continues Rare: focal seizures, with alexia and variable degree of dysphasia |
Considered a variety of GGE; described in patients with JME | Benign, thus well responding to treatment | Stimulus avoidance (interruption of reading) VPA first choice LEV and CLN as the second choice |
Eating epilepsy | 1/1,000–2,000 PWE, male/female: 3/1 | Unknown familial cluster in Sri Lanka | MECP2 | Focal seizures with or without impairment of awareness | Usually epilepsies with epileptogenic lesions | Variable | Stimulus modification, medication for focal epilepsy CLB before meal Surgery |
Hot water or bathing epilepsy | Rare (more common in India and Turkey), male predominance (70%) | Likely autosomal dominant | 10q21.3–q22.3 and 4q24–q28 Synapsin 1 GPR56 | Focal seizures | None | Relatively benign | Stimulus avoidance/modification (shortened bath times, decreasing the bath water temperature) BZD as needed |
Seizures induced by somatosensory stimuli | Rare, unknown | Unknown | Unknown | Sensory aura followed by a sensory Jacksonian seizure with tonic motor manifestations. Secondary generalization may occur | With MCD and post-santral cortical lesions | Variable | As for other symptomatic or focal epilepsies |
Seizures induced by proprioceptive stimuli | Rare, unknown | Usually none | Unknown | Myoclonic or somatomotor or somatosensorial seizures Evolvement focal to bilateral may occur | Acquired brain lesions non-ketotic hyperglycemia acute diffuse encephalopathies | Variable | Medication for focal seizures |
Seizures induced by orgasm | Very uncommon, female predominance | None | Unknown | Focal seizures | Usually with acquired lesions | Variable | Medication or surgery |
Seizures induced by thinking or praxis | Usually overlapping with JME | Usually overlapping with GGE | Unknown | Myoclonia, absence, GTCS | GGE | Benign (as JME) | Same medication as GGE |
Abbreviations: ADTLE, autosomal dominant temporal lobe epilepsy; BZD, benzodiazepines; CLB, clobazam; CLN, clonazepam; DS, Dravet syndrome; GGE, genetic generalized epilepsies; GTCS, generalized tonic-clonic seizures; IPOE, idiopathic photosensitive occipital lobe epilepsy; JME, juvenile myoclonic epilepsy; LEV, levetiracetam; LTG, lamotrigine; MCD, malformations of cortical development; PME, progressive myoclonus epilepsies; PWE, patients with epilepsy; VPA, valproic acid.