Self-induction is a mode of seizure precipitation employed by entirely normal or mentally impaired patients to produce seizures for themselves. Maneuvers for self-induction aim to provoke a seizure by producing optimal conditions of stimulation by flickering light (self-induced photosensitive epilepsy), patterns (self-induced pattern-sensitive epilepsy), proprioceptive stimuli or higher brain functions (self-induced noogenic epilepsy).
In my experience of 442 patients with onset of nonfebrile seizures from age 0 through 15 years only 5 (1.3%) had self-induced seizures.
Age of onset
The objective of self-induced seizures is relief of tension and anxiety, and escape from a disturbing situation.
One particular strategy for self-induction in photosensitive epilepsy is to look at a bright light source, usually the sun, and voluntarily wave the abducted fingers in front of the eyes (sunflower ) in order to produce optimal intermittent photic stimulation. Others do (1) repetitive opening and closing of the eyes or lateral or vertical rhythmic movements of the head in front of a bright light source; (2) make the television picture roll; (3) quickly change television channels while watching from a close distance; or (4) play video games.
Early forced eyelid blinking and flutter, eyelid jerks and oculoclonic activity may be ictal manifestations of the occipital lobes as documented with deep stereo- recordings which may not show in surface EEG.
Eyelid blinking and gaze-fixation to light may be a normal ‘attraction movement’ when light is presented and other manifestations of the optic fixation reflexes when volitional movements of the eyes are unattainable or weak.
Blinking functions as a complex indicator of phasic responses to stress such as that produced by listening to emotionally laden words.
*Expert opinion, please check FDA-approved indications and prescribing information
This page was adapted from:
The educational kit on epilepsies
Originally published by MEDICINAE
Reviewed and revised June 2008 by Steven C. Schachter, MD
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