Startle epilepsy (Startle-induced seizures)
Startle seizures are induced by sudden and unexpected stimuli. The startle (unexpected and sudden presentation of the stimulus) is the provoking factor, although, rarely, patients may be specifically sensitive to one modality. Sudden noise is the main triggering stimulus, but somatosensory and less often visual stimuli are also effective in some patients. Habituation to repetitive stimulation occurs.
Age at onset
Startle seizures are usually generalized tonic.
The startle response is brief (<30 sec); axial tonic posturing frequently causes falls, which are often traumatic. It is asymmetrical in 1/4 of patients. In hemiparetic patients, the seizure starts with flexion and abduction of the paretic arm and extension of the ipsilateral leg, which rapidly involve the contralateral side. Marked manifestations, automatisms, laughter, and jerks may occur concurrently. Atonic or myoclonic startle seizures are less common.
Infrequent spontaneous seizures are common (probably in all patients).
*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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