{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:59:51Z","timestamp":1747148391730,"version":"3.40.5"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Sunflower syndrome is a unique photosensitive epilepsy, characterized by heliotropism and stereotyped seizures associated with handwaving. These handwaving events (HWE) are thought to be an ictal phenomenon, although current data are contrasting. Photosensitive epilepsy occurs in 2%\u20135% of the epilepsy forms and several pathogenic gene variants have been associated with photosensitive epilepsy. However, the genetic etiology of Sunflower syndrome remains unknown. Antiseizure medications (ASM) efficacious in treating photosensitive epilepsy are valproic acid (VPA) and levetiracetam (LEV) although some forms, such as Sunflower syndrome, can be drug\u2010resistant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Here, we report an 8\u2010year\u2010old boy with an early onset of episodes of HWE that was initially categorized as behavioral problems for which risperidone was started. However, the medical history was suggestive of Sunflower syndrome, and subsequent video EEG showed focal mostly temporal and frontotemporal (right and left) epileptiform activity and confirmed the epileptic nature of the HWE. Thus, VPA was started and initially led to seizure frequency reduction. Molecular analyses showed a pathogenic variant in <jats:italic>GABRG2<\/jats:italic> (c.1287G&gt;A p.(Trp429Ter)), which has been associated with photosensitive and generalized epilepsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Overall, clinicians worldwide should be cautious by interpreting HWE and\/or other tic\u2010like movements, since an epileptic origin cannot be ruled out. A prompt and correct diagnosis can be made by performing a video EEG early on in the diagnostic process when epileptic seizures are part of the differential diagnosis. Even though the genetic etiology of Sunflower syndrome remains poorly understood, this constellation supports further genetic testing since the detection of a pathogenic variant can help in making correct decisions regarding ASM management.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epd2.20154","type":"journal-article","created":{"date-parts":[[2023,8,26]],"date-time":"2023-08-26T11:50:50Z","timestamp":1693050650000},"page":"815-822","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A novel <i>GABRG2<\/i> variant in Sunflower syndrome: A case report and video EEG monitoring"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5319-6495","authenticated-orcid":false,"given":"Jo","family":"Sourbron","sequence":"first","affiliation":[{"name":"Section Pediatric Neurology, Department of Development and Regeneration University Hospital KU Leuven  Leuven Belgium"},{"name":"Center for Medical 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Italy"},{"name":"IRCCS Istituto Giannina Gaslini  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten","family":"Eschermann","sequence":"additional","affiliation":[{"name":"Research Institute for Rehabilitation, Transition and Palliation Paracelsus Medical University  Salzburg Austria"},{"name":"Department of Pediatrics University Hospital of the Paracelsus Medical University  Salzburg Austria"},{"name":"Clinic for Neuropediatrics and Neurological Rehabilitation Epilepsy Center for Children and Adolescents, Sch\u00f6n Klinik Vogtareuth  Vogtareuth Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3645-762X","authenticated-orcid":false,"given":"James Richard","family":"Barnett","sequence":"additional","affiliation":[{"name":"Pediatric Epilepsy, Program Department of Neurology Massachusetts General Hospital  Boston Massachusetts 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