Restricted Frontomesial Epileptogenic Focus Generating Dyskinetic Behavior and Laughter
Authors:
Open Access
Abstract
Summary: Purpose: Substantial data are missing about the anatomic location of frontal regions supporting gelastic seizures. Methods: We report the results of stereo‐electro‐encep halographic recordings performed over several distinct functional premotor and executive fields in a patient whose seizures were characterized by dyskinetic behavior and ictal laughter, in the absence of cerebral MRI abnormalities. Results: The epileptogenic zone was circumscribed in the anterior and ventral part of the supplementary motor area and the underlying dorsal cingulate cortex. There were no or little spreading to cortical neighboring areas. The patient is seizure‐free (follow‐up of 27 months) after a stereotactic electric radiofrequency lesion of the epileptogenic focus. Conclusion: The present data suggest that pericingulate premotor areas are involved in the triggering of the motor component of laughter. In this case, the coexistence of paroxysmal dyskinesias during laughter might reflect the involvement of specific compartment(s) of the basal ganglia.Keywords
This publication has 24 references indexed in Scilit:
- “Supplementary motor area (SMA) seizure” rather than “SMA epilepsy” in optimal surgical candidates: a document of subdural mappingJournal of the Neurological Sciences, 2002
- Mirthful laughter induced by subthalamic nucleus stimulationMovement Disorders, 2001
- Pathological laughter and crying: A link to the cerebellumBrain, 2001
- Motor Areas of the Medial Wall: A Review of Their Location and Functional ActivationCerebral Cortex, 1996
- Paroxysmal dyskinesias: Clinical features and classificationAnnals of Neurology, 1995
- Human cingulate cortex: Surface features, flat maps, and cytoarchitectureJournal of Comparative Neurology, 1995
- Contributions of anterior cingulate cortex to behaviourBrain, 1995
- Mirth, laughter and gelastic seizuresBrain, 1993
- Multiple representations of body movements in mesial area 6 and the adjacent cingulate cortex: An intracortical microstimulation study in the macaque monkeyJournal of Comparative Neurology, 1991
- Architecture of superior and mesial area 6 and the adjacent cingulate cortex in the macaque monkeyJournal of Comparative Neurology, 1991