Advances in Childhood Reflex Epilepsies

Epileptic seizures can arise spontaneously without clear triggers, or they can be provoked by certain identifiable stimuli. Reflex epilepsy refers to a complex group of unique epilepsies where a clear trigger is often identified. These triggers can range from a passing song to elevated water temperature to food. The underlying etiology for reflex epilepsy can vary from structural brain abnormalities and to genetic disorders. Although reflex epilepsies are often grouped together as a single entity, the term encompasses several different forms of epilepsy, which have unique pathophysiological basis and treatment approaches. This special issue of Journal of Pediatric Epilepsy covers some of the important concepts about this fascinating group of conditions. We bring together an expert panel of epileptologists to review and discuss some carefully selected topics.

Dr. Alessandro Iodice delves into eating epilepsy, a specific form of reflex epilepsy, which is often precipitated by the thought of food or by the action of chewing. The article provides a wonderful summary of the literature regarding this rare epilepsy and details a case of eating epilepsy arising from the limbic system. Drs. Alcy Torres, Marleny Aquino-Cabrera, and Mugdha Mohanty provide a detailed review of hot water epilepsy, triggered by immersion or bathing. In these patients with aberrant thermoregulatory systems, focal seizures with impaired awareness are often the most common seizure type noted. Dr. Kapil Arya provides a comprehensive review of photosensitive epilepsy, perhaps the most widely known reflex epilepsy. He elucidates the general principles of pathophysiology and management of this condition. In addition, specific forms of photosensitive epilepsies, like idiopathic photosensitive occipital epilepsy, the Jeavons syndrome, and pattern-sensitive epilepsy, are discussed in further detail. In his article about musicogenic epilepsy, Dr. Ahmad Marashly reviews the commonly noted clinical features, semiology, and electroencephalogram findings in patients with this intriguing type of reflex epilepsy. Drs. Mohammed Ilyas, Kailash Pawar, and Mirza Baig review the general principles of treatment of childhood reflex epilepsies. The authors strive to summarize the treatment approach and an overview of management options for reflex epilepsy.

We hope that this special issue on reflex epilepsies will be a valuable resource to the general neurologists, as well as epileptologists. We thank all the contributing authors for their efforts and hard work in compiling this edition.