{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T13:16:31Z","timestamp":1782134191389,"version":"3.54.5"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2007,9,1]],"date-time":"2007-09-01T00:00:00Z","timestamp":1188604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2007,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>Paroxysmal tonic upgaze (PTU) is a childhood oculomotor syndrome of unclear etiology characterized by episodic tonic upward eye deviation with neck flexion. Neuroimaging findings are often normal and the electroencephalography during episodes is typically normal. We describe a 2\u2010year\u2010old boy who presented with macrocephaly, hypotonia, developmental delay and episodes of eye fluttering, head nodding and unresponsiveness. Video\u2010EEG captured absence seizures and he was treated with valproate, which led to improvement of his seizures. However, two weeks after treatment, he developed paroxysmal episodes of \u201ceyes up and chin down\u201d movements lasting for hours at a time which were captured by home video. The episodes were relieved by sleep and exacerbated by fever, stress and even tactile stimulation. Increasing the dose of valproate resulted in increased frequency of the episodes. A repeat video\u2010EEG disclosed the non\u2010epileptic nature of these events. Discontinuation of valproate dramatically decreased the episodes. This case illustrates that paroxysmal tonic upgaze of childhood may co\u2010exist with early onset absence epilepsy. Furthermore, valproate treatment may be associated with the development or unmasking of PTU suggesting that the pathophysiology of PTU may involve abnormal GABA neurotransmission.<\/jats:p>\n          <jats:p>\n            <jats:italic>[Published with videosequences]<\/jats:italic>\n          <\/jats:p>","DOI":"10.1684\/epd.2007.0119","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T14:49:05Z","timestamp":1711550945000},"page":"332-336","source":"Crossref","is-referenced-by-count":16,"title":["Paroxysmal tonic upgaze of childhood with co\u2010existent absence epilepsy"],"prefix":"10.1002","volume":"9","author":[{"given":"Aim\u00e9e F.","family":"Luat","sequence":"first","affiliation":[{"name":"Carman and Ann Adams Department of Pediatrics Childrens Hospital of Michigan Wayne State University Detroit Michigan USA"},{"name":"Department of Neurology Childrens Hospital of Michigan Wayne State University Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eishi","family":"Asano","sequence":"additional","affiliation":[{"name":"Carman and Ann Adams Department of Pediatrics Childrens Hospital of Michigan Wayne State University Detroit Michigan USA"},{"name":"Department of Neurology Childrens Hospital of Michigan Wayne State University Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry T.","family":"Chugani","sequence":"additional","affiliation":[{"name":"Carman and Ann Adams Department of Pediatrics Childrens Hospital of Michigan Wayne State University Detroit Michigan USA"},{"name":"Department of Neurology Childrens Hospital of Michigan Wayne State University Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,9]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.2.169"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21277"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1993.tb11666.x"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410310212"},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0887-8994(92)90041-V"},{"key":"e_1_2_3_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1528-1157.2002.13802.x"},{"key":"e_1_2_3_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410430416"},{"key":"e_1_2_3_9_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1303.003"},{"key":"e_1_2_3_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0197-0186(00)00013-9"},{"key":"e_1_2_3_11_1","doi-asserted-by":"publisher","DOI":"10.3928\/0191-3913-20030501-17"},{"key":"e_1_2_3_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/088307388800300305"},{"key":"e_1_2_3_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.braindev.2004.02.016"},{"key":"e_1_2_3_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcped.2006.10.013"},{"key":"e_1_2_3_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/088307380001500103"},{"key":"e_1_2_3_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1995.tb12014.x"},{"key":"e_1_2_3_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2001.tb01587.x"}],"container-title":["Epileptic Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1684\/epd.2007.0119","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T16:48:57Z","timestamp":1711558137000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1684\/epd.2007.0119"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,9]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2007,9]]}},"alternative-id":["10.1684\/epd.2007.0119"],"URL":"https:\/\/doi.org\/10.1684\/epd.2007.0119","archive":["Portico"],"relation":{},"ISSN":["1294-9361","1950-6945"],"issn-type":[{"value":"1294-9361","type":"print"},{"value":"1950-6945","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,9]]}}}