Don Renu Kaushalya Kalansooriya¹, Kumuduni Cooray¹, Rashmi Karunarathne¹, Piyumi Ranasinghe¹, Selvakumar Lventhini¹, Dinouki Paranavitana¹
1- District General Hospital, Awissawella, Sri Lanka
Corresponding Author:
Don Renu Kaushalya Kalansooriya (
renukd92@gmail.com)
Abstract Body
Introduction: Sunflower syndrome( self-induced photo sensitive epilepsy) is a rare epileptic disorder characterized by stereotyped behavior, comprising of obsessively seeking out light source ,staring at the light source and hand flapping in front of the eyes upon exposure to light. Case discussion: 6 year old neurodevelopmentally normal, otherwise healthy girl presenting with abnormal repetitive waving of the left hand in front of the face followed by excessive eye fluttering and occasional inattentiveness when exposed to bright lights, since the age of 3.5 years. The frequencies of these episodes were around 25 times/hour each lasting about 5 seconds hindering her school activities. The patient unfortunately , at first was misdiagnosed as having features suggestive of Autism spectrum disorder and was started on sertraline. She was referred to the pediatric clinic by the school teacher due to this seemingly unusual behavior. Her EEG revealed diffuse poly spike waves with normal background activity . She was started on sodium valproate which drastically reduced the seizure frequency .
Conclusion: Sunflower syndrome is described as a rare self-Induced, reflexive epilepsy syndrome with photic triggers. Its clinical features are both highly unique and specific. Pathogenesis of this syndrome is unclear but electroencephalography and imaging study have suggested cingulate circuit to be the anatomical substrate.EEG along with clinical history aid in the diagnosis of sunflower epilepsy . Though extremely refractory to treatment valproate, levetiracetam, ethosuximide, benzodiazapines and lamotrigine provide more effective treatment. Lack of awareness results in a diagnostic delay/misdiagnosis and leads to unnecessary investigations and adverse health impact to patient.