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A Case of Startle Epilepsy and SSMA Seizures Documented with Subdural Recordings
Author(s) -
Serles Wolfgang,
Leutmezer Fritz,
Pataraia Ekaterina,
Olbrich Achim,
Gröppel Gudrun,
Czech Thomas,
Baumgartner Christoph
Publication year - 1999
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.1528-1157.1999.tb00813.x
Subject(s) - ictal , epilepsy , frontal lobe , neuroscience , psychology , lesion , magnetic resonance imaging , temporal lobe , medicine , radiology , psychiatry
Summary:Purpose: To study the mechanisms of startle‐induced supplementary sensorimotor area (SSMA) seizures. Methods: We present a patient investigated with indwelling subdural grid electrodes covering both the SSMA and the dorsolateral frontal lobe. Results: We found a simultaneous seizure onset in the right dorsolateral premotor cortex and the right SSMA. High‐resolution magnetic resonance imaging (MRI) showed a small subcortical lesion adjacent to the right SSMA. The patient became seizure free after resection of the lesion and the ictalonset zone. Conclusions: We conclude that an extended region of abnormally excitable tissue within the frontal lobe could facilitate the generation of startle‐induced seizures. We speculate that a widespread epileptogenic zone could help to explain why some patients with SSMA or dorsolateral frontal lobe seizures are more likely to have startle‐induced seizures.