Eating Epilepsy: Pathophysiologic Models, Electroclinical Phenotypes, and Outcome

Eating epilepsy (EE) is a rare form of reflex epilepsy precipitated by food. Ictal semiology may vary depending on the etiology, age at onset, and cerebral areas involved in the epileptogenic network. In childhood, EE could manifest as tonic head drop seizures, generalized seizures, or late-onset epileptic spasms. However, in teenagers or adults, seizures are often preceded by aura and commonly manifest as focal seizures with or without impaired awareness. Brain magnetic resonance imaging abnormalities are seen in less than half of the reported cases. Posterior or multifocal interictal discharges can be seen in patients with EE. No randomized data about treatment are available. Structural epilepsies or coexistent unprovoked seizures other than eating seizures are poor prognostic factors for pharmacological outcome.