Journal Article Reports Instance of Drawing-Induced Epilepsy

EpilepsyUSA staff
Posted: July 20, 2006

In the March issue of the medical journal Neurology, researchers reported a case of reflex epilepsy triggered by drawing.

The report, written by Kuan H. Kho, M.D., of the University Medical Center Utrecht in the Netherlands, told the experience of a 19-year-old boy. At presentation, Kho said the boy had short-lasting twitches in both arms shortly before losing consciousness and exhibiting seizure-type activity for two minutes. When the symptoms began, the boy was drawing.

Kho and his associates performed an EEG on the patient, and the results showed spike and wave discharges in the right frontal and parietal lobes. These coincided with spasms of the arms, disorientation and an inability to resume drawing for up to 30 seconds.

The patient told the researchers he had experienced similar twitching and "special sensations" while drawing in the past, but not while engaged in any other activities. The scientists tested for other seizure-inducing stimuli, such as looking at pictures and writing. These activities did not produce EEG activity or any seizure-type symptoms.

"Cases of reflex seizures triggered by very specific activities, such as drawing, reading, writing or chess playing, are rare but important in understanding how the brain is organized and how seizures can occur," said Edward Bromfield, M.D., an associate professor of neurology at Harvard University and a member of the Epilepsy Foundation's professional advisory board.

"In this particular study, the patient seems to have an abnormally excitable network of cortical neurons that is closely connected to the neuronal network that underlies drawing, so the neuronal firing that normally occurs when he draws somehow 'ignites' the abnormal network and causes a seizure," Bromfield explained. "As in many such patients, the cause of the abnormal network is unknown, but the literature suggests this can be either inherited or acquired. Further study of these unusual cases can perhaps help us to understand how seizures are triggered in more common situations."