title: Eyelid myoclonia with absences: routine EEG is sufficient to make a diagnosis.
abstract: 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.
authors.affiliation: 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
authors.forename: Charuta Narayan
authors.initials: CN
authors.lastname: Joshi
authors.forename: Jill
authors.initials: J
authors.lastname: Patrick
mesh_terms: 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