Abstract
To evaluate the use of transparent goggles in the prevention of eye closure and subsequent seizures due to fixation-off sensitivity (FOS). An N-of-1 trial was conducted during which 7 consecutive cycles of showering with and without goggles were evaluated. We found 100% provocation of eyelid myoclonia during each cycle without goggle usage on daily review of smartphone videos with seizure freedom during each cycle with goggles. The semiology on smartphone videos was identical to absences with eyelid myoclonia confirmed by inpatient video-EEG monitoring. At the 6-month follow-up, subjective quality of life improved with no shower-related seizures, greater independence while bathing, and reduction of anticipatory anxiety. Transparent swimming goggles were effective in this N-of-1 trial to render a patient with drug-resistant epilepsy seizure-free and avert ongoing injury due to FOS. Behavioral modification is a critical adjunct to medical therapy in patients with fixation-off sensitivity.
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