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Periodic Lateralized Frontal Epileptiform Discharges with Ipsilateral Epilepsia Partialis Continua
Author(s) -
Young G. Bryan,
Blume Warren T.
Publication year - 2007
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.1528-1167.2007.00979.x
Subject(s) - epilepsia partialis continua , neuroscience , epilepsy , medicine , psychology , status epilepticus
Summary: Purpose: Lateralized clonic jerks of the extremities during epileptic seizures usually arise from the contralateral rolandic cortex. In our exceptional case one‐sided extremity twitches related to epileptiform activity in the ipsilateral frontal lobe. Methods: Case study with clinical‐electroencephalographic correlation. Results: A 47‐year‐old man suffered destruction of most of his right cerebral hemisphere, including the perirolandic region. Epilepsia partialis continua (EPC) ensued, with clonic jerks of the proximal right upper and lower limbs temporally related to periodic lateralized epileptiform discharges (PLEDs) from the parasagittal region of the right frontal lobe with a variable time interval over 100 ms. Sectioning of the subcortical callosal and projection connections of the frontal lobe abolished the clonic jerks. Conclusions: We propose the ipsilateral EPC arose from projections from the supplementary motor region to the medullary reticular formation to account for the long and variable latency between PLEDs and jerks.