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Eyelid myoclonia and absences in a 4-year-old boy (video-EEG)

Video-EEG of a 4-year-old boy with an 8-month history of facial movements and cognitive delay, who was referred for an EEG by a psychologist. The electroclinical symptoms of eyelid myoclonia and absences were noticed during a routine EEG, and a detailed sleep-awake video-EEG was arranged. During sleep, his eyes and mouth were slightly open, and frequent, brief generalized spike-and-wave discharges with no obvious clinical events were recorded. When awake, no discharges were triggered during blinking (twice between 11:03:45 and 11:03:47). On voluntary eye closure, eyelid tonic spasm and plateau at eye closure, followed by automatic eye opening with concomitant generalized spike-and-wave discharge and eyelid jerks, were evident. Discharges were provoked during intermittent photic stimulation with the eyes open as well. The photosensitivity range was 10 to 50 Hz. (Contributed by Athanasios Covanis MD PhD.)