ABSTRACT

We aimed to discuss the clinical and electrophysiological characteristics of a patient, who had refractory, pattern sensitive seizures with selfinduction as a rare clinical picture and markedly benefited from add-on zonisamide treatment. 14-year-old male who suffered from seizures since the age of 2.5 years, admitted with daily seizures that appeared suddenly and made him fall. Patterns of curtains or seats, fluorescent lights and shiny colored labels triggered his seizures. He often induced the episode himself and derived pleasure out of them. EEG showed widespread slowed and disorganized background activity, multifocal epileptogenic foci most prominent on the right posterior side of the hemispheres and generalized epileptiform discharges. He was diagnosed with an atypical Lennox –Gastaut syndrome with his clinical and EEG findings. The patient had no response to other anti-epileptic drugs but after adding zonisamide to his treatment, his seizures were significantly reduced and self-induction behavior disappeared in the follow-up of one year. In conclusion, zonisamide may show benefits in patients having a drug-resistant epilepsy with self induction and pattern sensitivity.

Keywords: Refractory epilepsy, Lennox-Gastaut syndrome, pattern sensitivity, self-induction, zonisamide