Eyelid myoclonia with absences: routine EEG is sufficient to make a diagnosis.
OBJECTIVE
To identify the prevalence, clinical characteristics and routine EEG features of the syndrome of eyelid myoclonia with absences (EMA) using a retrospective case control study design.


METHODS
EEGs from 1996 to 2005 were searched using the following keywords: eyelid flutter, eyelid blinking, tics, idiopathic generalized epilepsy, clinical absence, atypical absence and photoparoxysmal response. During the same period, patients with a diagnosis of idiopathic generalized epilepsy were identified. Patients with mainly eyelid fluttering/eyelid blinking as their seizure semiology were divided into EMA and non-EMA groups using previously published criteria and compared using parametric (Student's t-test) and non-parametric tests (Chi square) where appropriate. A p-value of <0.05 was considered significant.


RESULTS
The keywords identified 997 patients, 288 patients were diagnosed with idiopathic generalized epilepsy; 126 had eyelid fluttering/blinking as their major seizure semiology. After excluding 51 patients due to incomplete data, of 75 remaining patients, 26 (9.03%) had EMA. Patients with EMA were (1) older at time of first EEG (OR=2.86; 95% CI=7.00-10.23; p=0.005) (2) more likely to have an event on routine EEG (OR=3.62; 95% CI=1.28-10.19; p=0.01) (3) had >3 events per day (OR=9.73; 95% CI=2.06-45.96; p=0.0012) (4) had higher prevalence of developmental delay (OR=4.46; 95% CI=1.36-14.67; p=0.01) and (5) had normal EEG background compared to the non-EMA group.


CONCLUSIONS
EMA is not uncommon; diagnosis can be made with good clinical history and routine EEG. As developmental delay is a common association with EMA in this study, early identification and treatment are important.
Joshi
Charuta Narayan
CN
Section of Pediatric Neurology, Department of Pediatrics, Children's Hospital, AE 108 Harry Medovy House, 820 Sherbrook Street, Winnipeg, MB R3A1S1, Canada. cjoshi@hsc.mb.ca
Patrick
Jill
J
D017668:Age of Onset; D016022:Case-Control Studies; D004569:Electroencephalography; D004831:Epilepsies, Myoclonic / Q000175:diagnosis*; D004832:Epilepsy, Absence / Q000175:diagnosis*; D005143:Eyelids / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D014741:Video Recording