Ictal EEG and single photon emission computed tomography in a patient with cortical dysplasia presenting with atonic seizures

Epilepsia
M AiharaS Nakazawa

Abstract

Ictal studies of atonic seizures in children with epilepsy are rare. To clarify the neurophysiologic mechanism of such seizures, we describe a cluster of atonic seizures in a 6-year-old girl with cortical dysplasia. Ictal activity was recorded as slow-wave bursts beginning over the right frontocentral regions, where the cortical dysplasia was detected by magnetic resonance imaging (MRI), and propagating to the left hemisphere. The polygraphic recording demonstrated that the atonia indicated by the sudden interruption of electromyogram (EMG) discharges corresponded to the bilaterally synchronous spike-and-wave complexes. An ictal single photon emission computed tomography (SPECT) study with 99mTc hexamethyl propylene amine oxime ([99mTc]HMPAO) simultaneously performed during EEG recording showed marked bilateral mesial frontal and right frontoparietal hyperperfusion. Our findings suggest that the neurophysiological mechanism of the atonic seizures may be produced by a strong inhibition in the bilateral motor cortexes. Ictal SPECT is valuable in demonstrating the pathophysiology of both atonic seizures and secondary bilaterally synchronous spike-and-wave complexes in the EEG.

References

Sep 1, 1995·Electroencephalography and Clinical Neurophysiology·G RubboliC A Tassinari
Mar 1, 1994·Annals of Neurology·N LeeJ M Hoffman
Jun 1, 1993·The Japanese Journal of Psychiatry and Neurology·K FukushimaM Seino

❮ Previous
Next ❯

Related Concepts

Related Feeds

Absence Epilepsy

Absence epilepsy is a common seizure disorder in children which can produce chronic psychosocial sequelae. Discover the latest research on absence epilepsies here.