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Eyelid myoclonia and absences in an 8.5-year-old girl (2)

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Video-EEG images of an 8.5-year-old girl who was referred by a child psychologist following an assessment for educational problems and facial grimaces. At the age of 6 years, she started having eyelid jerks, but her parents believed that she was having tics. The sleep-awake video-EEG confirmed discharges and clinical phenomena on voluntary and on demand eye closure, which became worse during hyperventilation and intermittent photic stimulation. The photosensitivity range was 5 to 40 Hz. Note the girl’s attempts to avoid the clinical phenomena. Past and developmental histories were noncontributory. The response to sodium valproate monotherapy was complete and has remained so for the past 7 years. Although her school performance has shown some improvement, it has remained average. (Contributed by Athanasios Covanis MD PhD.)