A rare form of photosensitive epilepsy associated with a stereotyped behavior: the patient turns his or her head towards the sun (or a bright light) while making waving movements with one hand in front of the eyes. This form of epilepsy has long been considered as self-induced or a tic.

This behavior, or the presence of eyelid myoclonus, usually precedes the onset of epilepsy by 2 to 8 years. Thereafter, this behavior is a sign of a concomitant epileptic phenomenon triggered by the light that attracts the patient (heliotropism, hence the name of the syndrome): usually absence, sometimes tonic-clonic convulsions or myoclonus. In addition to sunlight, the trigger may be a video game or rapid light/dark alternation.

Onset is in the first decade of life, and the disease is more common in girls.

The differential diagnosis is behavioral disorder or Jeavons syndrome (eyelid myoclonus with or without brief absences) (see this term).

This type of epilepsy responds poorly to pharmacological treatment; trials with fenfluramine are currently underway. The best preventive strategy is to wear specially coloured glasses, a large hat and avoid the sun and bright lights.

Anesthetic implications:

avoid bright lights during induction, recovery and in the recovery room.

References : 

-         Geenen KR, Patel S, Thiele EA.
Sunflower syndrome: a poorly understood photosensitive epilepsy.
Developmental Medicine & Child Neurology 2021, 63: 259-62

Updated: April 2024