case_images: PMC8100049_01
case_images: Eyelid myoclonic status. The patient was continuously blinking with upward rolling of the eyeball and backward movement of the head; VEEG: sustained and extensive 3- to 6-Hz high-amplitude spike-slow wave, polyspike-slow wave discharge. (A) Fast blinking movement. (B) Slow blinking movement. X5, outer eyelid; X6, upper eyelid. SEN: 15 muV; HF: 70; TC: 0.3.
case_images: fped-09-671732-g0001.jpg
case_images: PMC8100049_01_fped-09-671732-g0001.jpg
case_images: F1
case_images: It showed persistent spike-wave, polyspike-wave discharge (Figure 1), especially when the eyes were closed.
case_images: Intermittent photic stimulation (IPS). After the patient had 2 Hz (A), 4 Hz (B), 6 Hz (C), 8 Hz (D), 10 Hz (E), 12 Hz (F), and 14 Hz (G), the epileptic discharges reduced or stopped. But after 16 Hz (H), 18 Hz (I), and 20 Hz (J), the epileptic discharges increased and blinking started again. X5, outer eyelid; X6, upper eyelid. SEN: 15 muV; HF: 70; TC: 0.3.
case_images: fped-09-671732-g0002.jpg
case_images: PMC8100049_01_fped-09-671732-g0002.jpg
case_images: F2
case_images: Hz frequency, the seizures and epileptic discharges reduced or stopped (Figure 2). However, after the patient had 16, 18, and 20 Hz, the epileptic discharges increased and blinking started again.
case_images: Tonic clonic seizures beginning in the occipital region 7 min after IPS. X5, outer eyelid; X6, upper eyelid. SEN: 15 muV; HF: 70; TC: 0.03.
case_images: fped-09-671732-g0003.jpg
case_images: PMC8100049_01_fped-09-671732-g0003.jpg
case_images: F3
case_images: Seven min after 20 Hz, the VEEG found a tonic-clonic seizure starting from the occipital region (Figure 3).
case_images: There was no epileptic discharge in VEEG 10 min after the administration of midazolam, and the background rhythm was about 8 Hz. X5, outer eyelid; X6, upper eyelid. SEN: 10 muV; HF: 70; TC: 0.1.
case_images: fped-09-671732-g0004.jpg
case_images: PMC8100049_01_fped-09-671732-g0004.jpg
case_images: F4
case_images: After 10 min, the EEG showed that the epileptic discharge disappeared and started recovering to normal state (Figure 4).