Differentiation between Complex Tic and Eyelid Myoclonia with Absences: Pediatric Case Report and Brief Review of the Literature

Eyelid Myoclonia with Absences (EMA) can often be clinically mistaken for a tic disorder. This case report describes a 4-year-old female who presented with eye fluttering and blinking accompanied by a hand gesture described as a “brow wipe” that was exacerbated by sunlight, warm temperatures, anxiety, and excitement. She was diagnosed with a transient tic disorder, and aripiprazole and clonazepam treatment partially decreased symptom intensity. She was stable for months, after which symptoms worsened with constant tics while in the sun and seeking light stimuli to induce an episode. Video electroencephalogr -am confirmed self-induced photosensitive seizures with generalized epileptiform discharges consistent with generalized seizures. The EMA diagnosis was confirmed by these characteristic eye closure-related discharges, and the patient was successfully treated with valproate. We also present a brief review of the literature that underscores the clinical similarities between EMA and tics, as well as the importance of timely implementation of appropriate treatment in EMA.