Teaching Video NeuroImage: Electroclinical characteristics of micturition-induced reflex epilepsy.

Chaturbhuj Rathore, MD Ashalatha Radhakrishnan, MD S. Dinesh Nayak, MD Kurupath Radhakrishnan, MD, FAAN A 6-year-old boy presented with seizures since the age of 3 years characterized by sudden extension of the upper extremities and a tendency to fall forward; each seizure was induced by micturition. The ictal EEG during these seizures showed 20 Hz beta activity followed by 2 Hz spike-wave discharges confined to the Cz electrode (figure, video). Among the six patients with micturitioninduced seizures documented so far in the literature, a midline or right medial frontal epileptogenic focus has been consistently documented.1 Although a high resolution MRI in our patient failed to define any focal abnormality, presence of an occult hyperexcitable dysplastic lesion cannot be excluded.2