Epilepsy in the vibroacoustic disease: a case report.
BACKGROUND
Late-onset epilepsy was one of the first neurological problems identified in patients diagnosed with vibroacoustic disease. Other clinical situations, such as automatisms and rage-like reaction crises were also observed. Some cases of epileptic seizures were triggered by different types of stimuli.


METHODS
This study describes the clinical case of a 30-yr-old male metal-worker who had epileptic seizures when he used vibratory tools common to his profession, such as drills and sanders. We performed a 21-channel EEG during a seizure induced in the laboratory by direct contact of a vibratory tool with his right hand. This allowed us to view the electrical discharge of his left hemisphere. The entire procedure was simultaneously videotaped while a partial motor crisis was observed. Brain MRI of this subject revealed multiple hyperintense focal lesions in the sub-cortical white matter. Echocardiography revealed thickening of the pericardium and valve structures.


CONCLUSIONS
To the authors' knowledge, this is the first documented case of reflex epilepsy due to vibratory stimuli. We briefly discuss the possible pathophysiological mechanisms of this clinical event.
Martinho Pimenta
A J
AJ
Santo António dos Capuchos Hospital, Lisbon, Portugal.
Castelo Branco
N A
NA
D000328:Adult; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis* / Q000209:etiology*; D005073:Evoked Potentials, Somatosensory; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008669:Metallurgy; D009623:Noise, Occupational / Q000009:adverse effects*; D009784:Occupational Diseases / Q000175:diagnosis* / Q000209:etiology*; D014732:Vibration / Q000009:adverse effects*; D014743:Videotape Recording