Epileptic seizures triggered by the use of a powered toothbrush

BACKGROUND Reflex epilepsy is characterized by seizures that are triggered in response to a specific stimulus and tooth-brushing epilepsy is an extremely rare form of reflex epilepsy in which the seizures are mainly induced by the act of tooth brushing. In this report, we describe an epilepsy patient whose seizures were exclusively triggered by the use of a powered toothbrush. METHODS AND RESULTS A 31-year old female had been treated for partial epilepsy of left temporal or frontal lobe for 20 years and she did not have seizures for the last 3 years. However, she experienced periods of auras, partial complex seizures, and nocturnal generalized seizures after she started using a powered toothbrush. The interictal electroencephalography revealed slow wave paroxysm over the left temporal or frontal lobe. CONCLUSIONS This case report is, to our knowledge, the first report of reflex epilepsy in which the seizures were triggered by the use of a powered toothbrush. Possible mechanisms to explain the novel type of this rare disorder are discussed.