A study of 72 children with eyelid myoclonia precipitated by eye closure in Yogyakarta

This is a report of 72 children in Yogyakarta with predominant feature of eyelid myoclonia over a 10year period from 1990-1999. The mean age of presentation was 7.4 years. Eighty-two percent were males. There were two siblings (4%) with similar illness. All the patients had absence. In 6% of the cases, the absence was mild. Other seizure manifestations such as head nod, head rotation, lateral or upward eye deviation, arm jerks, and automatism such as chewing, lip smacking, throat clearing, hand rubbing were seen in some of the patients. All patients also had hyperactivity behavior or inattentiveness. None had generalized tonic clonic seizure. Ictal and interictal EEG showed generalized discharges. Eye closure precipitated the eyelid myoclonia in all the cases. Photoconvulsive response was seen in 17%. All the patients with photoconvulsive response had generalized 3-6 Hz polyspike and slow wave, and higher proportion with other seizure manifestations including automatism when compared to patients without photoconvulsive response. There was good response to clonazepam. At 6 months of followup, 57% had excellent response with total absence of eyelid myoclonia and co-existent seizure, 26% had good response with occasional eyelid myoclonia and absence of co-existent seizure, and 17% had fair response with reduction of the eyelid myoclonia and the seizure. At 3 years of follow-up, 90% had excellent response and 10% had good response. Conclusion: The differences of our patients with previously reported cases of eyelid myoclonia with absence suggest that its manifestation is broader than previously described. Yogyakarta. There may be associated head nods, lateral ocular deviation and brief alteration of consciousness with amnesia. The patient also had hyperactive behavior, but no family history of epilepsy. Electroencephalography (EEG) showed generalized spike-waves complex. The patient responded to 0.5 mg of clonazepam. Since then, the author has seen numerous other similar patients. This is a description of 72 of the cases.