Background: Abnormal ocular movements may also mimic epileptic seizures, such as in paroxysmal tonic upward gaze, blepharospasm, ocular tics, and paroxysmal eyelid movements (PEM). From a diagnostic, management and prognostic perspective it is important to undertake an accurate assessment of whether abnormal ocular movements are epileptic in origin or not. Case Presentation: We present a child from a tertiary paediatric epilepsy centre in the United Kingdom with PEM associated with photoparoxysmal responses, which was a source of diagnostic confusion. EEG recordings captured the PEM episodes to confirm the diagnosis. Conclusion: The presentation of children with epilepsy with ocular abnormal movements, particularly in the presence of photoparoxysmal responses, should raise suspicion of possible PEM. Confirmation is essential by capturing these events on EEG.

Keywords: Epilepsy, myoclonia, non-epileptic, EEG, case report.