Lego®-induced seizures: From an exceptional case towards the building blocks of generalised epilepsy

Abstract

Reflex seizures are seizures that are elicited by sensory or cognitive stimuli. These stimuli can be very diverse but are usually highly specific within one patient. The type of seizures that are induced by these stimuli can be tonic-clonic seizures, myoclonic jerks with or without absences, and absences with facial myoclonus. Focal seizures can also occur. A wide range of different stimuli have been reported. The most well-known type of stimulus is flickering light (lights at a dance party, television screen). Some of the more specific examples are:micturition/defecation-induced epilepsy and Mahjong (a Chinese game) -induced epilepsy. An example of focal seizures are telephone induced seizures, with epileptic discharges in the lateral temporal lobe of the dominant hemisphere. Seizures provoked solely by specific stimuli are considered to be rare. However, seizures provoked by stimuli in idiopathic generalised epilepsy (IGE), especially juvenile myoclonic epilepsy (JME), are not uncommon. Photostimulation is the most common stimulus in JME patients, but various other stimuli have been described. A stimulus consisting of a specific task combining sensory and cognitive stimuli leads to so-called praxis-induced seizures. We report a patient with a seizure induced by playing with Lego bricks. To our knowledge, a case of a Lego-induced seizure has never been reported before.