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Case Reports
. 2018 Apr;97(15):e0299.
doi: 10.1097/MD.0000000000010299.

Occipital epilepsy versus progressive myoclonic epilepsy in a patient with continuous occipital spikes and photosensitivity in electroencephalogram: A case report

Yudan Lv  1 , Nan Zhang, Chang Liu, Mingchao Shi, Li Sun
Affiliations
Case Reports

Occipital epilepsy versus progressive myoclonic epilepsy in a patient with continuous occipital spikes and photosensitivity in electroencephalogram: A case report

Yudan Lv et al. Medicine (Baltimore). 2018 Apr.

Abstract

Introduction: Progressive myoclonic epilepsy (PME) is rare epilepsy syndrome. Although EEG is a useful neurophysiological technique in the evaluation of epilepsy, few EEG abnormalities have been described in PME. So, how to use EEG hints to establish the suspected diagnosis of PME as soon as possible should be addressed.

Case present: We presented a case with refractory myoclonic seizures, and progressive neurological deterioration, diagnosed as PME and neuronal ceroid lipofuscinosis disease by gene testing. The patient manifested with a significant regression in her speech ability and motor balance. The mini-mental state examination showed poor scores of 15/30. The magnetic resonance imaging showed diffused atrophy. Her EEG showed slow background with continuous occipital small spikes and photosensitivity. The following genetic testing with mutation in CLN6 confirmed the diagnosis and excluded the occipital epilepsy.

Conclusion: Our case showed rare manifestations and special EEG features of PME, which may be confused with occipital epilepsy or photosensitive epilepsy. Thus, if the continuous occipital spikes and photosensitivity were presented in a patient with refractory seizures and developmental regression, PME should be considered.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Diffused atrophy in cerebral cortex in magnetic resonance imaging (MRI).
Figure 2
Figure 2
Slow activity in background with continuous spike or spike-slow wave in occipital lobe (A); continuous spike or spike-slow wave presented in bipolar montage (B).
Figure 3
Figure 3
Generalized polyspike and spike-slow complex wave synchronized to the tonic-clonic seizure in ictal EEG.
See this image and copyright information in PMC

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