Eating Epilepsy in Oman: A case series and report on the efficacy of temporal lobectomy

Abstract

Eating epilepsy (EE), where seizures are triggered by eating, is rare and has not been reported in the Gulf region. In EE, the ictal semiology includes partial or generalised seizures. Focal brain changes on imaging, if present, are often confined to the temporal lobe or perisylvian region. Therapeutic options, especially in those patients who are refractory to pharmacotherapy, have not been well-established. We report a series of five patients with EE from Oman, a country located in the eastern part of the Arabian Gulf region, and highlight the usefulness of temporal lobectomy in one patient who had medically-intractable EE. Surgical intervention could be considered as a potential therapeutic option in carefully selected patients with medically-intractable seizures.

Keywords: Case report; Eating induced epilepsy; Oman; Reflex epilepsy; Temporal lobectomy.

Figure 1:

Electroencephalogram (EEG) of Case 1 with eating epilepsy (temporolimbic type). Long-term video EEG showed isolated interictal epileptiform discharges mainly arising from the left mid-temporal region (arrow).

Figure 2:

(A) Case 2 with temporolimbic eating epilepsy. The electroencephalogram shows bursts of right fronto-temporal epileptiform discharges. (B) Magnetic resonance imaging brain scan showing right temporal horn dilatation (block arrow) and left anterior temporal atrophy (long arrow).