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Epilepsia Partialis Continua: Epileptogenic Focus in Motor Cortex and Its Participation in Transcortical Reflexes

Epilepsia Partialis Continua: Epileptogenic Focus in Motor Cortex and Its Participation in... Abstract • We performed electrophysiologic and neuroradiologic studies on a patient who had epilepsia partialis continua (EPC) to elucidate the pathophysiologic mechanism of repeated myoclonic jerks confined to the right toes. A computed tomographic scan revealed a small cortical lesion in the left parasagittal rolandic area corresponding to the sensorimotor cortex of the right toes. A pretrigger EEG analysis with a jerk-locked averaging technique revealed a positive spike 32 ms before the jerks. A similar positive spike was evoked at a latency of 48 ms after an electrical stimulation of the right posterior tibial nerve; it was followed by a myoclonic jerk with a 32-ms latency. We suppose that in our patient, an epileptogenic focus in the motor cortex and transcortical long-loop reflexes played an important role in generating EPC. References 1. Koshewnikow AY: Eine besondere Form von corticaler Epilepsie . Neurol Zentralbl 1895; 14:47-48. 2. Chatrian GE, Shaw CM, Plum F: Clinical and pathological correlation in two cases . Electroencephalogr Clin Neurophysiol 1964;16:387-393.Crossref 3. Juul-Jensen P, Denny-Brown D: Epilepsia partialis continua: A clinical, electroencephalographic, and neuropathological study of nine cases . Arch Neurol 1966;15:563-578.Crossref 4. Kristansen K, Kaada BR, Henriksen GF: Epilepsia partialis continua . Epilepsia 1971; 12:263-267.Crossref 5. Boetz MI, Brossard L: Epilepsia partialis continua with well-delineated subcortical frontal tumor . Epilepsia 1974;15:39-43.Crossref 6. Kugelberg E, Widén L: Epilepsia partialis continua . Electroencephalogr Clin Neurophysiol 1954;6:503-506.Crossref 7. Bancaud J, Bonis A, Talairach J, et al: Syndrome de Kojewnikow et accès somatomoteurs (étude clinique, EEG, EMG et SEEG) . Encéphale 1970;59:391-493. 8. Siegrried J, Bernoulli C: Stereo-electroencephalographic exploration and epilepsia partialis continua . Acta Neurochir Suppl 1976;23:183-191. 9. Thomas JE, Reagan TJ, Klass DW: Epilepsia partialis continua: A review of 32 cases . Arch Neurol 1977;34:266-275.Crossref 10. Wieser HG, Graf HP, Bernoulli C, et al: Quantitative analysis of intracerebral recordings in epilepsia partialis continua . Electroencephalogr Clin Neurophysiol 1978;44:14-22.Crossref 11. Shibasaki H, Kuroiwa Y: Electroencephalographic correlates of myoclonus . Electroencephalogr Clin Neurophysiol 1975;39:455-463.Crossref 12. Lindenberg R, Fisher RS, Durlacher SM, et al: Lesions of the corpus callosum following blunt mechanical trauma to the head . Am J Pathol 1955;31:297-317. 13. Pagni CA, Ettore G, Infuso L, et al: EMG responses to capsular stimulation in the human . Experientia 1964;20:691-692.Crossref 14. Sutton GG, Mayer RF: Focal reflex myoclonus . J Neurol Neurosurg Psychiatry 1974; 37:207-217.Crossref 15. Shibasaki H, Yamashita Y, Kuroiwa Y: Electroencephalographic studies of myoclonus: Myoclonus-related cortical spikes and high amplitude somatosensory evoked potentials . Brain 1978;101:447-460.Crossref 16. Hallett M, Chadwick D, Marsden CD: Cortical reflex myoclonus . Neurology 1979;29:1107-1125.Crossref 17. Kelly JJ Jr, Sharbrough MD, Daube JR: A clinical and electrophysiological evaluation of myoclonus . Neurology 1981;31:581-589.Crossref 18. Goldring S, Aras E, Weber PC: Comparative study of sensory input to motor cortex in animals and man . Electroencephalogr Clin Neurophysiol 1970;29:537-550.Crossref 19. Kakigi R, Shibasaki H, Kuroiwa Y, et al: Short latency somatosensory evoked potentials by stimulation of posterior tibial nerve. Read before the 12th Annual Meeting of the Japan Society of EEG and EMG, Yonago, Japan, Oct 27, 1982. 20. Marsden CD, Merton PA, Morton HB: Stretch reflex and servo action in a variety of human muscles . J Physiol 1976;259:531-560. 21. Chauvel P, Louvel J, Lamarche M: Transcortical reflexes and focal motor epilepsy . Electroencephalogr Clin Neurophysiol 1978;45:309-318.Crossref 22. Cruse R, Klem G, Lesser RP, et al: Paradoxical lateralization of cortical potentials evoked by stimulation of posterior tibial nerve . Arch Neurol 1982;39:222-225.Crossref 23. Gath I: Effect of drugs on the somatosensory evoked potentials in myoclonic epilepsy . Arch Neurol 1969;20:354-357.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Epilepsia Partialis Continua: Epileptogenic Focus in Motor Cortex and Its Participation in Transcortical Reflexes

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1984.04050210038011
Publisher site
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Abstract

Abstract • We performed electrophysiologic and neuroradiologic studies on a patient who had epilepsia partialis continua (EPC) to elucidate the pathophysiologic mechanism of repeated myoclonic jerks confined to the right toes. A computed tomographic scan revealed a small cortical lesion in the left parasagittal rolandic area corresponding to the sensorimotor cortex of the right toes. A pretrigger EEG analysis with a jerk-locked averaging technique revealed a positive spike 32 ms before the jerks. A similar positive spike was evoked at a latency of 48 ms after an electrical stimulation of the right posterior tibial nerve; it was followed by a myoclonic jerk with a 32-ms latency. We suppose that in our patient, an epileptogenic focus in the motor cortex and transcortical long-loop reflexes played an important role in generating EPC. References 1. Koshewnikow AY: Eine besondere Form von corticaler Epilepsie . Neurol Zentralbl 1895; 14:47-48. 2. Chatrian GE, Shaw CM, Plum F: Clinical and pathological correlation in two cases . Electroencephalogr Clin Neurophysiol 1964;16:387-393.Crossref 3. Juul-Jensen P, Denny-Brown D: Epilepsia partialis continua: A clinical, electroencephalographic, and neuropathological study of nine cases . Arch Neurol 1966;15:563-578.Crossref 4. Kristansen K, Kaada BR, Henriksen GF: Epilepsia partialis continua . Epilepsia 1971; 12:263-267.Crossref 5. Boetz MI, Brossard L: Epilepsia partialis continua with well-delineated subcortical frontal tumor . Epilepsia 1974;15:39-43.Crossref 6. Kugelberg E, Widén L: Epilepsia partialis continua . Electroencephalogr Clin Neurophysiol 1954;6:503-506.Crossref 7. Bancaud J, Bonis A, Talairach J, et al: Syndrome de Kojewnikow et accès somatomoteurs (étude clinique, EEG, EMG et SEEG) . Encéphale 1970;59:391-493. 8. Siegrried J, Bernoulli C: Stereo-electroencephalographic exploration and epilepsia partialis continua . Acta Neurochir Suppl 1976;23:183-191. 9. Thomas JE, Reagan TJ, Klass DW: Epilepsia partialis continua: A review of 32 cases . Arch Neurol 1977;34:266-275.Crossref 10. Wieser HG, Graf HP, Bernoulli C, et al: Quantitative analysis of intracerebral recordings in epilepsia partialis continua . Electroencephalogr Clin Neurophysiol 1978;44:14-22.Crossref 11. Shibasaki H, Kuroiwa Y: Electroencephalographic correlates of myoclonus . Electroencephalogr Clin Neurophysiol 1975;39:455-463.Crossref 12. Lindenberg R, Fisher RS, Durlacher SM, et al: Lesions of the corpus callosum following blunt mechanical trauma to the head . Am J Pathol 1955;31:297-317. 13. Pagni CA, Ettore G, Infuso L, et al: EMG responses to capsular stimulation in the human . Experientia 1964;20:691-692.Crossref 14. Sutton GG, Mayer RF: Focal reflex myoclonus . J Neurol Neurosurg Psychiatry 1974; 37:207-217.Crossref 15. Shibasaki H, Yamashita Y, Kuroiwa Y: Electroencephalographic studies of myoclonus: Myoclonus-related cortical spikes and high amplitude somatosensory evoked potentials . Brain 1978;101:447-460.Crossref 16. Hallett M, Chadwick D, Marsden CD: Cortical reflex myoclonus . Neurology 1979;29:1107-1125.Crossref 17. Kelly JJ Jr, Sharbrough MD, Daube JR: A clinical and electrophysiological evaluation of myoclonus . Neurology 1981;31:581-589.Crossref 18. Goldring S, Aras E, Weber PC: Comparative study of sensory input to motor cortex in animals and man . Electroencephalogr Clin Neurophysiol 1970;29:537-550.Crossref 19. Kakigi R, Shibasaki H, Kuroiwa Y, et al: Short latency somatosensory evoked potentials by stimulation of posterior tibial nerve. Read before the 12th Annual Meeting of the Japan Society of EEG and EMG, Yonago, Japan, Oct 27, 1982. 20. Marsden CD, Merton PA, Morton HB: Stretch reflex and servo action in a variety of human muscles . J Physiol 1976;259:531-560. 21. Chauvel P, Louvel J, Lamarche M: Transcortical reflexes and focal motor epilepsy . Electroencephalogr Clin Neurophysiol 1978;45:309-318.Crossref 22. Cruse R, Klem G, Lesser RP, et al: Paradoxical lateralization of cortical potentials evoked by stimulation of posterior tibial nerve . Arch Neurol 1982;39:222-225.Crossref 23. Gath I: Effect of drugs on the somatosensory evoked potentials in myoclonic epilepsy . Arch Neurol 1969;20:354-357.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Oct 1, 1984

References