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Gelastic seizures with dancing arising from the anterior prefrontal cortex
Author(s) -
Neilson John,
Snyder Tom,
Pugh Jeff,
Wheatley Matt,
TangWai Richard
Publication year - 2014
Publication title -
epileptic disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.673
H-Index - 53
eISSN - 1950-6945
pISSN - 1294-9361
DOI - 10.1684/epd.2014.0659
Subject(s) - ictal , cortical dysplasia , neuroscience , lesion , psychology , epilepsy , prefrontal cortex , temporal lobe , cognition , psychiatry
Aim . This case report provides insight into the function of the anterior prefrontal cortex (aPFC), specifically Brodmann Area 10 (BA10), and its interconnectivity. Method . We present a 10‐year‐old patient with lesional epilepsy and ictal onset, localised to BA10 in the aPFC. Results . Thirty‐four seizures were recorded. All seizures involved a demonstration of elation with laughter that was associated with a variety of different patterns of complex motor behaviour that included performing specific celebratory movements and acting out a Michael Jackson dance move. Electrographically, the seizures were all stereotyped and arose from the right frontal region, followed by a distinct left temporal ictal rhythm that corresponded with the onset of the behaviours. The lesion in the right aPFC was identified as a mixed lesion with both dysembryoplastic neuroepithelial tumour cells and type II cortical dysplasia. Conclusion . The electrographic analysis and unique seizure semiology suggest a connection between the aPFC and the contralateral temporal lobe. This neural pathway appears to be involved in the activation of previously formed procedural memories, creating an intensely positive emotional experience.