Fixation off sensitivity and other Eye condition related epileptiform discharges, an institutional cohort (4090)

This is the authors' abstract. We don't add key points for this paper.

Objective: To describe the clinical, electrophysiological, imaging correlates of this uncommon EEG phenomenon of eye condition related epilepsies in patients presenting to a tertiary care centre in South India Background: Eye condition related epileptiform activities are very rare and interesting phenomena. These include, fixation off sensitivity (FOS), Eye closure sensitivity (ECS), scotosensitivity (SS) FOS is the appearance of epileptiform activity when the central vision fixation is eliminated. ECS- is related to the mechanism of eye closure. Scotosensitivity is the sensitivity to complete darkness. Design/Methods: Prospective collection of data over past 1 year from EEG database. ECG done using 10–20 system and screened with IED having the sensitivity to eye closure and opening. FOS was confirmed by Frenzel glasses, making the patient look to a white paper close to eye at a distance of 15 cm and using goggles with semitransparent tapes pasted over it. Also recorded in darkness with opaque tape pasted goggle to identify scotosensitivity. Detailed history, examination and imaging done. Results: Over 1000 EEGs screened, we identified 5 patients with eye condition related discharges. 4 patients were children and one adult (21 years). Prevalence in adults is extremely rare. FOS was noted in 4 patients, two were symptomatic, one cryptogenic and one Gastaut epilepsy. ECS was noted in one patient and was diagnosed as Gastaut epilepsy. One EEG was showing generalized discharges with FOS which is considered extremely rare. In our patient, there was generalised discharges with frontal dominance which was not described elsewhere in literature. Conclusions: 1. FOS and ECS are rare and interesting EEG phenomena which can be screened with simple eye opening and closure manouvre, and can be demonstrated by simple techniques as described. 2. Persistence of FOS in adulthood should prompt extensive search for Focal cortical malformations and celiac disease. 3. Identification of childhood idiopathic occipital epilepsies based on these phenomena have treatment implications Disclosure: Dr. Chandran has nothing to disclose. Dr. Kumar has nothing to disclose. Dr. Becket has nothing to disclose. Dr. Nagaraj has nothing to disclose. Dr. DC has nothing to disclose. Dr. Kumar has nothing to disclose.