Reflex reading epilepsy: Effect of linguistic characteristics on spike frequency

Reading epilepsy is a rare reflex epilepsy in which seizures are provoked by reading. Several cases have been described in the literature, but the pathophysiological processes vary widely and remain unclear. We describe a 42-year-old male patient with reading epilepsy evaluated using clinical assessments and continuous video/EEG recordings. We administered verbal, nonverbal, and reading tasks to determine factors precipitating seizures. Linguistic characteristics of the words were manipulated. Results indicated that reading-induced seizures were significantly more numerous than those observed during verbal and nonverbal tasks. In reading tasks, spike frequency significantly increased with involvement of the phonological reading route. Spikes were recorded predominantly in left parasagittal regions. Future cerebral imaging studies will enable us to visualize the spatial localization and temporal course of reading-induced seizures and brain activity involved in reading. A better understanding of reading epilepsy is crucial for reading rehabilitation in these patients.

Research highlights
► To date, the pathophysiology of reading epilepsy remains unclear and varies widely.
► A 42-year-old male patient with reading epilepsy is described.
► Language assessment was carried out under continuous video/EEG recordings.
► Linguistic factors known to affect lexical and phonological reading were manipulated.
► Phonological reading was responsible for highest spike frequency in the patient.