Correspondence

Audiogenic Epilepsy Induced by a Specific Television Performer

N Engl J Med 1991; 325:134-135July 11, 1991

Article

To the Editor:

A number of factors, such as fatigue, sleep deprivation, and menstruation, may aggravate epileptic seizures. In about 5 percent of patients the seizures are triggered by specific sensory stimuli.1 A case of photosensitive epilepsy induced by a video game has been reported in the Journal.2 I wish to describe a patient in whom seizures were precipitated by the voice of a specific person on a popular television show.

A 45-year-old right-handed woman presented with a four-year history of recurrent episodes of a feeling of pressure in the head, epigastric distress, and mental confusion. These episodes were triggered by the voice of a female cohost on a popular television entertainment program. Two years after the onset of these symptoms, the patient began to have blackout spells that occurred when she was not watching the television program, and she was treated with phenytoin. Her neurologic examination was normal, as was magnetic resonance imaging of the head. Electroencephalography after sleep deprivation was normal. During four subsequent videoelectroencephalographic recording sessions, the patient's complex partial seizures were consistently triggered from the right temporal region by a videotape of the specific television show. Systematic testing revealed that the seizures were precipitated only by the voice of the female cohost and not by visual stimulation, emotional anticipation, or background music; by other programs with a similar format; or by other female voices. During a two-year follow-up the patient remained relatively seizure-free by assiduously avoiding the specific program and taking a combination of carbamazepine and divalproex sodium (for blackout spells). She declined behavior therapy aimed at specific voice desensitization.

Forster et al. described a 53-year-old woman in whom seizures were triggered by the voices of three male radio announcers.3 In that case, specific voice stimulation induced epileptiform activity in the left temporal lobe. The voice-induced activation of right-temporal-lobe activity in my patient may be due to the lateralization of affective language to the nondominant hemisphere.4 The cause of the seizures in this patient is unknown. Photogenic epilepsy5 and certain types of reading epilepsy6 are genetically determined. The patient had no family history of epilepsy, and inherited audiogenic seizures have not been reported in humans. Genetically determined susceptibility to audiogenic seizures is well recognized in certain strains of mice,7 but the relevance of this finding to human epilepsy is unknown.

Venkat Ramani, M.D.
Albany Medical College, Albany, NY 12208

7 References

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Citing Articles (1)

Citing Articles

1. 1

   S. Grosso, M.A. Farnetani, E. Bernardoni, G. Morgese, P. Balestri. (2007) Intractable reflex audiogenic seizures in Aicardi syndrome. Brain and Development 29:4, 243-246
   CrossRef