Identification of Interictal Paroxysmal Diffuse Sharp Activity with Eye Closure in Patients with Generalized Epilepsy

Abstract

Interictal EEG recordings of patients with generalized epilepsy have known interictal abnormalities such as generalized spike and wave activity during photic stimulation and hyperventilation, interictal spike and wave or diffuse sharp activity [1]. We report three patients with confirmed generalized epilepsy who’s interictal recordings showed paroxysmal diffuse sharp 10 Hz activity in all leads with eye closure following eye blinking. This pattern was not associated with interictal generalized spike and wave activity, clinical change in the patient or did not follow seizure activity. Abnormal eye movement with generalized spike and wave activity has been described in Jeavon’s syndrome, eyelid myotonia and Sunflower syndrome. However, our patients did not meet criteria for any of these diagnoses. Therefore, we feel that our finding of paroxysmal diffuse sharp alpha activity is a novel finding in these patients with primary generalized epilepsy and may be a newly reported marker for patients with primary generalized epilepsy. Recognition of PDSA activity and further study of this pattern is encouraged.