Chapter 103 - Reflex epilepsy with higher-level processing

Summary

The seizures of reflex epilepsy are reliably precipitated by some identifiable factor. Reports of higher-level triggers such as calculation, reading, and thinking pre-date modern imaging and epilepsy monitoring. This chapter considers seizures induced by thinking and action programming (planned action or praxis), reading and other language-related triggers, and some related stimuli. Functional magnetic resonance imaging (fMRI) shows activations in most subjects in areas overlapping or adjacent to those physiologically activated during language and facial motor tasks, including subcortical structures, without significant lesions. Treatments for these reflex seizures are medical and nonmedical. General advice to avoid sleep deprivation and alcohol excess is given, especially since juvenile myoclonic epilepsy is typically worsened by sleep deprivation. Patients with reading epilepsy may decline medication if they do not have generalized convulsive seizures. Antiepileptic drugs for generalized epilepsies are usually effective, especially when combined with non-medical approaches.