Motor Manifestations in Epileptic Photosensitivity: Clinical Features and Pathophysiological Insights

Guido Rubboli *, Elena Gardella, Stefano Meletti

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingBook chapterResearchpeer-review

Abstract

A wide spectrum of motor phenomena are associated with epileptic photosensitivity. In this chapter, we will give an overview of the most common clinical manifestations of epileptic photosensitivity focusing in particular on visually induced epileptic motor phenomena such as eyelid myoclonia with absences (EMA) and photic reflex myoclonus (PRM), providing some insights into their pathophysiological mechanisms.

In EMA, current evidences by multimodal imaging and neurophysiological techniques support the hypothesis of an intrinsic “visuo-motor hyperexcitability.” The demonstration that this upregulation is detectable under resting (unstimulated) conditions and even during the alpha rhythm, the hallmark of the brain resting state, indicates a probable genetic predisposition to generate synchronous paroxysmal activity.

In PRM, neurophysiological investigations suggest that this myoclonic phenomenon requires the participation of both occipital and motor cortices. The excitatory activity elicited by the visual stimulus in the occipital cortex spread to the central motor cortex, generating a myoclonic volley that propagates down the spinal cord via fast-conducting corticospinal pathways.
Original languageEnglish
Title of host publicationThe Importance of Photosensitivity for Epilepsy
EditorsDorothee Kasteleijn-Nolst Trenite
PublisherSpringer
Publication date2021
Pages185-197
ISBN (Print)978-3-319-05079-9
ISBN (Electronic)978-3-319-05080-5
DOIs
Publication statusPublished - 2021

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