Additional options for non-pharmacological treatment of epilepsy

Abstract

Objective: to study the effect of blue polarizing glasses on photosensitivity in patients with photosensitive epilepsy (PSE). Materials and methods. On the backdrop of red light stimulation, EEG and daytime video EEG recordings were performed in 19 patients with epilepsy (15 women, 4 men) aged from 14 to 41 years. Among those, 8 patients had juvenile myoclonic epilepsy (JME), 2 – eyelid myoclonus with absences, 6 – generalized epilepsy, 1 – juvenile absence epilepsy (JAA), and 2 patients had unspecified (cryptogenic) focal epilepsy. All patients underwent photo-stimulation (PS) with an increasing light frequency from 1 to 31 Hz (in 3 Hz steps). The PS procedure was carried out twice: without and with the use of blue polarizing glasses with a degree of darkness of 50%.Results. In 19 patients with PSE, we observed a photo-paroxysmal response at frequencies of 10, 13, 15, 16, 19, and 21 Hz. In the same individual, this photo-paroxysmal response could have manifested either in a burst of epileptic activity without clinical symptoms or in myoclonus / myoclonia with absences. In 8 (42.1%) patients, there was a decrease in epileptic activity upon photo-stimulation: a decrease in the duration of the acute peak-slow-wave activity or a zero epileptic activity at one frequency on the backdrop of a notable epileptic activity at other frequencies. In 3 (15.8%) patients, who were using the blue glasses, there were neither seizures nor epileptic activity at all. In one case (5.3%), there was no seizure but the PS-induced epileptiform activity did occur. The disappearance of subclinical epileptic activity was noted in 2 (10.5%) cases.Conclusion. Blue polarizing glasses can be used as an additional means of non-pharmacological therapy of PSE. The protective effect may be associated with a decrease in the melatonin content in the daytime.