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Restricted Frontomesial Epileptogenic Focus Generating Dyskinetic Behavior and Laughter
Author(s) -
Chassag Serge,
Minotti Lorella,
Kremer Stephane,
Verceuil Laurent,
Hoffmann Dominique,
Benabid Alim Louis,
Kahane Philippe
Publication year - 2003
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1046/j.1528-1157.2003.60802.x
Subject(s) - ictal , neuroscience , supplementary motor area , laughter , basal ganglia , psychology , gelastic seizure , premotor cortex , epilepsy , dorsum , medicine , anatomy , functional magnetic resonance imaging , central nervous system , hypothalamic hamartoma , precocious puberty , hormone
Summary: Purpose: Substantial data are missing about the anatomic location of frontal regions supporting gelastic seizures. Methods: We report the results of stereo‐electro‐encep halographic recordings performed over several distinct functional premotor and executive fields in a patient whose seizures were characterized by dyskinetic behavior and ictal laughter, in the absence of cerebral MRI abnormalities. Results: The epileptogenic zone was circumscribed in the anterior and ventral part of the supplementary motor area and the underlying dorsal cingulate cortex. There were no or little spreading to cortical neighboring areas. The patient is seizure‐free (follow‐up of 27 months) after a stereotactic electric radiofrequency lesion of the epileptogenic focus. Conclusion: The present data suggest that pericingulate premotor areas are involved in the triggering of the motor component of laughter. In this case, the coexistence of paroxysmal dyskinesias during laughter might reflect the involvement of specific compartment(s) of the basal ganglia.