The electroclinical manifestations and natural history of reading epilepsy (RE) in 20 patients diagnosed between 1949 and 1989 are reported from the Mayo Clinic, Rochester, Minnesota. Age at onset ranged from 10 to 46 years (median 17 years). Juvenile myoclonic epilepsy occurred in 4, and a positive family history for epilepsy in 4, with RE in 1. Seizures were myoclonic, involving orofacial and jaw muscles, and the upper limbs also in 5. Generalized tonic-clonic seizures occurred at least once in 16. The EEG showed generalized spike or spike-and wave discharges in 15 cases and left hemisphere discharges in 5. RE was persistent into late adult life but not progressive; it responded to valproic acid. Higher cognitive processes acting as trigger mechanisms other than reading included calculation in 6, speaking under stress in 5, writing in 2, and playing chess in 1. [1]

COMMENT. The authors dedicate their article to Dr Reginald G Bickford on his 81st birthday and we add our congratulations! Bickford (1954) and Bickford, Klass et al (1956) first described the syndrome of reading epilepsy and stressed the importance of precipitating factors in the mechanism of seizures and EEG epileptiform discharges in general. Christie S (1988) found a combination of factors involved in the precipitation of reading epilepsy: saccadic eye movements, articulation, and difficulty of linguistic content. Bickford had alluded to the degree of difficulty of reading matter in his original article. (See Progress in Pediatric Neurology I, 1991, p45).