Recent advance on photosensitive occipital lobe epilepsy_Journal of Epilepsy

Authors：

WANG Xuemei , LI Minting , TANG Fen ,  QIN Bing

Epilepsy Center, Department of Neurosurgery, The First Hospital of Jinan University, Guangzhou 510630, China;

Corresponding author：

QIN Bing, Email: qb900@163.com

Keywords：

Photosensitive occipital lobe epilepsy; Visually-induced epilepsy; Flashing stimuli

DOI：

10.7507/2096-0247.202406004

Video：

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Photosensitive occipital lobe epilepsy (POLE) is a rare idiopathic reflex focal epilepsy that can occur in all age groups. It is characterized by occipital lobe seizures induced by flashing stimuli (flashing sunlight, video games, TV commercials and programs, etc.). Photoparoxysmal response on EEG is induced by intermittent photic stimulation; Ictal EEG shows rapid spike rhythms are originated from the occipital region. There are no obvious abnormalities in brain image. POLE responds well to anti-seizure medications and has a good prognosis. This article reviews the research progress on POLE in order to improve the clinician’s understanding and reduce the rates of missed diagnosis and misdiagnosis.

Citation： WANG Xuemei, LI Minting, TANG Fen, QIN Bing. Recent advance on photosensitive occipital lobe epilepsy. Journal of Epilepsy, 2024, 10(4): 328-331. doi: 10.7507/2096-0247.202406004 Copy

1.	Guerrini R, Dravet C, Genton P, et al. Idiopathic photosensitive occipital lobe epilepsy. Epilepsia, 1995, 36(9): 883-891.
2.	Engel Jr J. A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE Task Force on Classification and Terminology. Epilepsia, 2001, 42(6): 796-803.
3.	Engel Jr J. Report of the ILAE Classification Core Group. Epilepsia, 2006, 47(9): 1558-1568.
4.	Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: Report of the ILAE Commission on Classification and Terminology, 2005–2009. Epilepsia, 2010, 51(4): 676-685.
5.	Specchio N, Wirrell EC, Scheffer I E, et al. International League Against Epilepsy classification and definition of epilepsy syndromes with onset in childhood: position paper by the ILAE Task Force on Nosology and Definitions. Epilepsia, 2022, 63(6): 1398-1442.
6.	Koutroumanidis M, Tsirka V, Panayiotopoulos C. Adult-onset photosensitivity: clinical significance and epilepsy syndromes including idiopathic (possibly genetic) photosensitive occipital epilepsy. Epileptic Disorders, 2015, 17(3): 275-286.
7.	Cerrahoğlu Şirin T, Yılmaz T, Elmalı AD, et al. Photosensitive occipital lobe epilepsy: delineation of an under-recognized reflex epilepsy syndrome according to the new ILAE criteria and long-term follow-up. Epileptic Disorders, 2023, 25(2): 187-199.
8.	Taylor I, Marini C, Johnson MR, et al. Juvenile myoclonic epilepsy and idiopathic photosensitive occipital lobe epilepsy: is there overlap? Brain, 2004, 127(8): 1878-8186.
9.	Sadleir LG, De Valles-Ibáñez G, King C, et al. Inherited RORB pathogenic variants: overlap of photosensitive genetic generalized and occipital lobe epilepsy. Epilepsia, 2020, 61(4): e23-e29.
10.	Yavuz E, Ozdemir O, Demirkan A, et al. Investigation of the possible association of NEDD4-2 (NEDD4L) gene with idiopathic photosensitive epilepsy. Acta Neurologica Belgica, 2014, 115: 11265.
11.	Parra J, Lopes Da Silva FH, Stroink H, et al. Is colour modulation an independent factor in human visual photosensitivity? Brain, 2007, 130(6): 1679-1689.
12.	Politi-Elishkevich K, Kivity S, Shuper A, et al. Idiopathic photosensitive occipital epilepsy: clinical and electroencephalographic (EEG) features. Journal of Child Neurology, 2013, 29(3): 307-311.
13.	Guerrini R, Bonanni P, Parmeggiani L, et al. Adolescent onset of idiopathic photosensitive occipital epilepsy after remission of benign rolandic epilepsy. Epilepsia, 1997, 38(7): 777-781.
14.	Bonini F, Egeo G, Fattouch J, et al. Natural evolution from idiopathic photosensitive occipital lobe epilepsy to idiopathic generalized epilepsy in an untreated young patient. Brain and Development, 2014, 36(4): 346-350.
15.	Taylor I, Berkovic SF, Scheffer IE. Genetics of epilepsy syndromes in families with photosensitivity. Neurology, 2013, 80(14): 1322-1329.
16.	Chilosi AM, Brovedani P, Moscatelli M, et al. Neuropsychological findings in idiopathic occipital lobe epilepsies. Epilepsia, 2006, 47(s2): 76-78.
17.	Brinciotti M, Mittica A, Matricardi M. Characteristics of visual evoked potentials related to the electro-clinical expression of reflex seizures in photosensitive patients with idiopathic occipital lobe epilepsy. Epilepsy Research, 2020, 164: 265-268.
18.	Verrotti A, Tocco AM, Salladini C, et al. Human photosensitivity: from pathophysiology to treatment. European Journal of Neurology, 2005, 12(11): 828-841.
19.	Fisher RS, Acharya JN, Baumer FM, et al. Visually sensitive seizures: an updated review by the Epilepsy Foundation. Epilepsia, 2022, 63(4): 739-768.
20.	Shuper A, Vining EPG. Photosensitive complex partial seizures aggravated by phenytoin. Pediatric Neurology, 1991, 7(6): 471-472.

1. Guerrini R, Dravet C, Genton P, et al. Idiopathic photosensitive occipital lobe epilepsy. Epilepsia, 1995, 36(9): 883-891.
2. Engel Jr J. A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE Task Force on Classification and Terminology. Epilepsia, 2001, 42(6): 796-803.
3. Engel Jr J. Report of the ILAE Classification Core Group. Epilepsia, 2006, 47(9): 1558-1568.
4. Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: Report of the ILAE Commission on Classification and Terminology, 2005–2009. Epilepsia, 2010, 51(4): 676-685.
5. Specchio N, Wirrell EC, Scheffer I E, et al. International League Against Epilepsy classification and definition of epilepsy syndromes with onset in childhood: position paper by the ILAE Task Force on Nosology and Definitions. Epilepsia, 2022, 63(6): 1398-1442.
6. Koutroumanidis M, Tsirka V, Panayiotopoulos C. Adult-onset photosensitivity: clinical significance and epilepsy syndromes including idiopathic (possibly genetic) photosensitive occipital epilepsy. Epileptic Disorders, 2015, 17(3): 275-286.
7. Cerrahoğlu Şirin T, Yılmaz T, Elmalı AD, et al. Photosensitive occipital lobe epilepsy: delineation of an under-recognized reflex epilepsy syndrome according to the new ILAE criteria and long-term follow-up. Epileptic Disorders, 2023, 25(2): 187-199.
8. Taylor I, Marini C, Johnson MR, et al. Juvenile myoclonic epilepsy and idiopathic photosensitive occipital lobe epilepsy: is there overlap? Brain, 2004, 127(8): 1878-8186.
9. Sadleir LG, De Valles-Ibáñez G, King C, et al. Inherited RORB pathogenic variants: overlap of photosensitive genetic generalized and occipital lobe epilepsy. Epilepsia, 2020, 61(4): e23-e29.
10. Yavuz E, Ozdemir O, Demirkan A, et al. Investigation of the possible association of NEDD4-2 (NEDD4L) gene with idiopathic photosensitive epilepsy. Acta Neurologica Belgica, 2014, 115: 11265.
11. Parra J, Lopes Da Silva FH, Stroink H, et al. Is colour modulation an independent factor in human visual photosensitivity? Brain, 2007, 130(6): 1679-1689.
12. Politi-Elishkevich K, Kivity S, Shuper A, et al. Idiopathic photosensitive occipital epilepsy: clinical and electroencephalographic (EEG) features. Journal of Child Neurology, 2013, 29(3): 307-311.
13. Guerrini R, Bonanni P, Parmeggiani L, et al. Adolescent onset of idiopathic photosensitive occipital epilepsy after remission of benign rolandic epilepsy. Epilepsia, 1997, 38(7): 777-781.
14. Bonini F, Egeo G, Fattouch J, et al. Natural evolution from idiopathic photosensitive occipital lobe epilepsy to idiopathic generalized epilepsy in an untreated young patient. Brain and Development, 2014, 36(4): 346-350.
15. Taylor I, Berkovic SF, Scheffer IE. Genetics of epilepsy syndromes in families with photosensitivity. Neurology, 2013, 80(14): 1322-1329.
16. Chilosi AM, Brovedani P, Moscatelli M, et al. Neuropsychological findings in idiopathic occipital lobe epilepsies. Epilepsia, 2006, 47(s2): 76-78.
17. Brinciotti M, Mittica A, Matricardi M. Characteristics of visual evoked potentials related to the electro-clinical expression of reflex seizures in photosensitive patients with idiopathic occipital lobe epilepsy. Epilepsy Research, 2020, 164: 265-268.
18. Verrotti A, Tocco AM, Salladini C, et al. Human photosensitivity: from pathophysiology to treatment. European Journal of Neurology, 2005, 12(11): 828-841.
19. Fisher RS, Acharya JN, Baumer FM, et al. Visually sensitive seizures: an updated review by the Epilepsy Foundation. Epilepsia, 2022, 63(4): 739-768.
20. Shuper A, Vining EPG. Photosensitive complex partial seizures aggravated by phenytoin. Pediatric Neurology, 1991, 7(6): 471-472.

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