Recurrent partial tonic postural seizures precipitated by slow movements unrelated to cognitive tasks are reported in a 16-year-old right-handed boy treated at Instituto di Clinica delle Malattie Nervose e Mentali, Rome, Italy. Performing repetitive flexion-extension of the right hand fingers, as in feeling coins in his pocket, induced a tonic posturing of the right arm followed by extension of the left hand and deviation of the head to the left. The ictal EEG showed brief voltage attenuation followed by 4-Hz sharp wave discharge in frontal-central regions, maximal left. Interictal SPECT showed hypoperfusion in the right frontal-central area. Carbamazepine treatment had completely controlled seizures at 22 month follow-up. [1]

COMMENT. Reflex seizures induced by movement have been reported previously, sometimes in patients with nonketotic hyperglycemia of diabetes mellitus.