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Prefrontal seizures manifesting as motor stereotypies
Author(s) -
McGonigal Aileen,
Chauvel Patrick
Publication year - 2014
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.25718
Subject(s) - stereotypy , ictal , psychology , stereoelectroencephalography , neuroscience , epilepsy , supplementary motor area , frontal lobe , context (archaeology) , prefrontal cortex , cognition , functional magnetic resonance imaging , paleontology , amphetamine , dopamine , biology
ABSTRACT Background The definition of stereotypies traditionally does not include “epileptic automatisms.” However repetitive, sometimes rhythmic behaviors can occur during frontal lobe seizures in a reproducible pattern for a given patient. Thus, the concept of a frontostriatal “motor loop” could be relevant to repetitive ictal behaviors. Methods We describe 17 patients with frontal lobe epilepsy who presented with motor and/or verbal stereotypies and who were explored using depth electrodes (stereoelectroencephalography [SEEG]) in the context of epilepsy presurgical evaluation. Results Motor patterns were typically reproducible between seizures for a given patient. Distal motor stereotypies were associated with anterior prefrontal localization, and proximal stereotypies were associated with posterior prefrontal localization. Conclusions “Stereotypy” is a useful term to describe ictal repetitive behaviors produced by prefrontal seizure discharge. The expression of distal and proximal stereotypies follows a rostrocaudal gradient within the frontal lobes. Exploration of the cortical compartment of frontostriatal networks in epileptic patients offers a unique opportunity to study the mechanisms of stereotypies in vivo. © 2013 International Parkinson and Movement Disorder Society