1. MRI-negative frontal lobe epilepsy with ipsilateral akinesia and reflex activation
- Author
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Stephen, Malone, Ian, Miller, Prasanna, Jakayar, Trevor, Resnick, Sanjiv, Bhatia, and Michael, Duchowny
- Subjects
Male ,Dyskinesias ,Adolescent ,Epilepsy, Frontal Lobe ,Movement ,Electroencephalography ,Neuropsychological Tests ,Hand ,Magnetic Resonance Imaging ,Functional Laterality ,Neurosurgical Procedures ,Seizures ,Reflex ,Humans - Abstract
The pre-operative assessment and surgical management of children and young adults with MRI-negative, frontal lobe epilepsy is often challenging owing to the semiologic expression being unusual or non-lateralizing. Localization based on functional tests may be non-convergent, further compounding the difficulty of surgical planning. We describe a patient with seizures presenting with early, subjective akinesia of the dominant hand that were at times triggered by repetitive motor tasks. Subdural EEG monitoring revealed seizure-origin in the ipsilateral dorsolateral frontal lobe. After resective surgery the patient has had a seizure free period of 9 months, and is free of deficits. This is the first report of frontal lobe seizure semiology consisting of ipsilateral ictal akinesia.
- Published
- 2008