All You Need To Know about Sunflower Syndrome

What is Sunflower Syndrome?

Also known as helianthine or visual photosensitivity, sunflower syndrome is a rare neurological condition characterized by an abnormal sensitivity to bright lights, especially sunlight. A unique feature of this syndrome is that during the seizure, the affected child turns towards a bright light source and keeps waving one hand in front of his or her eyes. These seizures cause brief, repetitive jerking movements, often involving hands or arms.

Sunflower syndrome is a type of reflex epilepsy where specific sensory stimuli can trigger seizures.

Types of Seizures in Sunflower Syndrome

The seizure can very in severity, but commonly seen types include;

1. Photosensitive seizures

Typically, sunflower syndrome is triggered by exposure to light, primarily sunlight. It is called sunflower syndrome because the sunflower always faces the sun. During these seizures, the affected children face the sun or any bright light source. The seizures are accompanied by brief, repetitive jerking movements (myoclonus), particularly in the hands and arms.

2. Absence seizures

This type of seizure is characterised by sudden, brief lapses in consciousness wherein a child may appear to stare blankly into space for a few seconds and then quickly return to normal activity, often without any memory of the event. These seizures can occur independently or be triggered by light stimuli.

3. Generalised Tonic-Clonic seizures

Although less common, generalised tonic-clonic seizures can also occur in children with sunflower syndrome. These seizures involve a combination of muscle rigidity (tonic phase) followed by rhythmic muscle contractions (clonic phase). They are more severe than photosensitive or absence seizures and can pose significant risks, such as injury from falling.

4. Myoclonic seizures

Children with sunflower syndrome may experience other myoclonic seizures that are not necessarily triggered by light. These involve sudden, brief, involuntary muscle jerks that can affect body parts.

Causes

The exact cause of sunflower syndrome is not known. However, as it takes place in childhood, it can be presumed that it has a genetic factor to it. Some factors are as follows:

• Genetic factors

• Neurological disorder

• Environmental triggers like exposure to strong light

• Developmental aspect due to the growing brain between ages 3 and 10; the brain may get sensitive towards sunlight

• Hormonal changes

• Stress

• Sleep disorders

Diagnosis

To diagnose sunflower syndrome, doctors will

• Take a detailed medical history

• Use video-EEG monitoring,

• Conduct a photosensitivity testing to observe the affected child's behaviour and corresponding brain activity.

Treatment Options for Sunflower Syndrome

Treatment focuses on reducing seizure frequency and managing symptoms using medications, behavioural interventions, and environmental changes such as wearing sunglasses. Here are the primary treatment options —

1. Medications

Anti-seizure medications are commonly used to control seizures. The choice of medicine prescribed by the doctor depends on the child's symptoms and response to treatment.

2. Behavioural interventions

Behavioural strategies, such as cognitive-behavioural therapy (CBT) and behavioural modification techniques, can help manage compulsive behaviours associated with sunflower syndrome and improve social functioning.

3. Environmental modifications

Wearing tinted sunglasses can help filter out triggering light wavelengths, reducing the frequency of seizures. Using hats to shield the eyes from direct sunlight and avoiding bright, flickering lights and stable lighting sources indoors can also be beneficial.

4. Lifestyle adjustments

Implementing lifestyle changes can also help manage sunflower syndrome. This includes maintaining regular sleep patterns to reduce overall brain excitability, regular physical activity, and stress management techniques like mindfulness and relaxation exercises.

5. Support and education

It is essential to educate and support patients and their families. This includes teaching patients about their condition, triggers, and management strategies and educating family members to recognise and respond appropriately to seizures.

Medical Monitoring and Adjustments

Following up regularly with a healthcare provider to monitor the effectiveness of the treatment plan will help the children diagnosed with sunflower syndrome cope with the condition.

A treatment plan usually includes —

• EEG monitoring:

Tracking changes in seizure activity and response to treatment.

• Medication adjustments:

Tweaking dosages or trying different medications if seizures are not adequately controlled.