ABSTRACT
This case study documents a patient who experienced bradycardia brought on by flash stimulation during a routine outpatient EEG recording. The patient had known photosensitive seizures in the past. During this routine EEG, the patient's heart rate dropped to about 12 beats per minute with the EEG displaying slow-delta-frequency waves with no epileptiform spikes or sharp waves. During immediate follow-up, in our emergency department, the patient had a brief asystolic event, followed by bradycardia. Cardiology examinations were normal. We propose that this response was a photic-triggered reflex vasovagal reaction.
Subject(s)
Bradycardia/etiology , Electroencephalography/adverse effects , Photic Stimulation/adverse effects , Syncope, Vasovagal/etiology , Bradycardia/physiopathology , Brain/physiopathology , Heart Rate/physiology , Humans , Male , Syncope, Vasovagal/physiopathology , Young AdultABSTRACT
PURPOSE: To report three patients in whom focal epilepsy developed shortly after painful soft tissue injuries to their hands. METHODS: Case reports. RESULTS: The attacks started in the injured hand. No evidence was found of an underlying brain lesion by history or from imaging studies. CONCLUSIONS: These cases suggest the possibility that the injuries led to a plastic change in the sensory/motor cortex, leading to increased excitability and ultimately to seizures. This suggests that epileptogenesis can occur in response to painful peripheral stimuli in some individuals.
