Reading epilepsy in a patient with previous idiopathic focal epilepsy withcentrotemporal spikes

Rationale: Reading epilepsy (RE) is a form of reflex epilepsy currently cla ssified as an idiopathic localization-related epilepsy (ILAE, 1989). Method s: We describe a 30 year-old right-handed male who suffered since the age o f 8 from nocturnal partial motor seizures. Clinical features were typical o f BECT. We reviewed the EEG recorded at that time which showed centro-tempo ral spike and waves. He was seizure-free from the age of 12 to the age of 1 7 when seizures evoked only by reading appeared. No other stimuli provoked seizures. Neurological and neuroradiological (CT and MR) investigations wer e normal. Baseline video-polygraphic EEC recordings were normal while readi ng aloud provoked myoclonic jerks in the facial muscles related to bilatera l spike and wave discharges. Therapy with carbamazepine and valproic acid s trongly reduced seizure frequency. Conclusion: Recent papers have debated the difficulties in classifying RE a mong the generalized or focal syndromes. Literature reports describe an ass ociation with RE and juvenile myoclonic epilepsy, supporting the hypothesis of an idiopathic generalized form. We report the first documented case wit h a clear-cut idiopathic localization-related epilepsy evolving to a primar y reading epilepsy.