Case series of Epilepsy with Palpebral Myoclonus.

Abstract

Introduction: epilepsy with palpebral myoclonus is an idiopathic generalized childhood epilepsy, which is underdiagnosed because it is confused with tics or behavioral actions.

Patients and methods: quantitative, observational, descriptive of 16 patients with epilepsy and myoclonic eyelids treated at an institution specialized in neurology, between the years 2017 and 2022. Clinical histories and videoelectroencephalograms were evaluated.

Results: of 16 patients, 11 were women (68.8%), the median age was 17.5 years (IQR 12.5). The first diagnosis most frequently received by patients was idiopathic generalized epilepsy. Stressful situations were the most reported precipitant. 93.75% of the patients initially presented palpebral myoclonic seizures and after several years presented generalized tonic-clonic seizures. The time elapsed between the first seizure and the diagnosis varied between 1 and more than 40 years, being greater among patients with a subsidized health system. Men had a high frequency of family history of epilepsy in the first and second degrees of consanguinity, had a longer delay in diagnosis and reported greater drug resistance. In both women and men, the posterior regions (occipital, temporoccipital and parietoccipital) presented a greater focal epileptiform activity. The photoparoxysmal response occurred with greater predominance in women, with the Waltz type III and IV responses being the most frequent.

Conclusion: the importance of suspecting this pathology before palpebral myoclonus in children should be highlighted, guaranteeing quality and timely management.