Premium
Tooth‐Brushing Epilepsy: A Report of a Case with Structural and Functional Imaging and Electrophysiology Demonstrating a Right Frontal Focus
Author(s) -
O'Brien Terence J.,
Hogan Robert E.,
Sedal Leslie,
Murrie Vanessa,
Cook Mark J.
Publication year - 1996
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1996.tb00636.x
Subject(s) - ictal , reflex epilepsy , epilepsy , neuroscience , precentral gyrus , magnetic resonance imaging , medicine , psychology , supplementary motor area , functional imaging , reflex , functional magnetic resonance imaging , radiology
Summary: Patients with reflex epilepsies may provide insights into cerebral pathophysiology. We report a patient with an unusual form of reflex epilepsy in whom seizures are induced by tooth brushing. Magnetic resonance imaging (MRI) demonstrated a right posterior frontal low‐grade tumor predominantly involving the precentral gyrus. Video‐telemetry demonstrated right‐sided epileptiform activity during a typical induced complex partial seizure. An ictal single photon emission computed tomography (SPECT) scan showed an area of hyperfusion that corresponded to the MRI lesion on coregistration with a surface‐matching technique. A subsequent coregistered interictal SPECT scan demonstrated hypoperfusion in the same region. Ours is the first report to demonstrate a structural focus in this unusual form of reflex epilepsy. Possible mechanisms to explain the induction of the seizures are discussed.