Purpose

It is well known that repetitive flash stimulation may trigger seizures in susceptible individuals. Nevertheless, reports of such incidents occurring during recording of a flash electroretinogram (ERG) are extremely rare. Here, we describe the case of a photic-induced seizure triggered during an ERG recording in the absence of a history of epilepsy or other paroxysmal events.

Methods

A 14-year-old male patient presented with reduced visual acuity and impaired mesopic vision. Ophthalmological exams confirmed the patient’s complaints but were inconclusive as to the underlying pathophysiology. An ERG recording was performed, during which the 30-Hz flicker stimulus triggered a seizure.

Results

The ERG was essentially normal, with the exception of a 7-Hz rhythm superimposed onto the flicker ERG response that was recorded when the seizure developed.

Conclusions

The present case highlights the possibility that the 30-Hz ERG flash stimulus triggers a seizure in patients with no previous paroxysmal events. Literature evidence suggests that the likelihood of such an incident could be reduced by stimulating monocularly.

中文翻译：

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在没有癫痫病史的患者中由闪烁的视网膜电图触发的癫痫发作

目的

众所周知，重复的闪光刺激可能会引发易感个体的癫痫发作。然而，在记录闪光视网膜电图 (ERG) 期间发生此类事件的报告极为罕见。在这里，我们描述了在没有癫痫病史或其他阵发性事件的情况下，在 ERG 记录期间触发的光诱发癫痫发作的情况。

方法

一名 14 岁男性患者出现视力下降和中视视力受损。眼科检查证实了患者的主诉，但对于潜在的病理生理学尚无定论。进行了 ERG 记录，在此期间 30 Hz 闪烁刺激触发了癫痫发作。

结果

ERG 基本上是正常的，除了在癫痫发作时记录的闪烁 ERG 响应上叠加了 7 Hz 节律。

结论

本案例强调了 30-Hz ERG 闪光刺激在以前没有阵发性事件的患者中触发癫痫发作的可能性。文献证据表明，通过单眼刺激可以降低发生此类事件的可能性。