A 12-year-old girl with a 2-year history of absence seizures induced by reading and diagnosed by video EEG is reported from The University of Texas Southwestern Medical Center, Dallas, and Riyadh Armed Forces Hospital, Saudi Arabia. The reading of complex material especially, either silently or aloud, produced staring episodes lasting several seconds and occasionally followed by headaches. Attacks were one to two a day at first and later increased to five to six daily. Two siblings had a history of febrile seizures. Routine EEG, including hyperventilation and photic stimulation, was normal. Video-EEG showed no spontaneous seizures in a 6-hour baseline period, but hyperventilation induced generalized 3-Hz spike-and-wave discharges and a clinical absence seizure. Reading in Arabic from the Koran for 30 seconds induced an absence seizure lasting 30 seconds. The reading challenge repeated several times at 10-minute intervals induced absences within 30 seconds. Valproate therapy given for 2 years controlled seizures, and she has been seizure-free for 9 months since stopping treatment. The EEG is normal, both during prolonged reading and hyperventilation. [1]
COMMENT. The electroclinical manifestations and natural history of reading epilepsy in 20 patients was recently reported from the Mayo Clinic (see Ped Neur Briefs May 1995). Seizures were myoclonic, involving orofacial and jaw muscles, and generalized tonic-clonic seizures occurred in 16. The reading epilepsy persisted into late adult life. It resonded to valproic acid. The reading-induced absence seizures in the present report appear to be unique and previously unreported. The precipitating stimuli for reading epilepsy are reviewed in Progress in Pediatric Neurology I, PNB Publ, 1991, pp 45-46.