Interhemispheric interactions analyzed by coherence during flexor spasms.
OBJECTIVE
We used coherence analysis to test for leading discharges on an ipsilateral right mesial temporal lesion in a 5 year old boy with flexor spasms.


METHODS
Digital EEG analysis with video-EEG telemetry was performed preparatory to epilepsy surgery.


RESULTS
Study of 10 spasms with head drop and subsequent flexion of both arms demonstrated an interhemispheric time lag with secondary bilateral synchrony, with a mean difference of 17 ms. The right hemisphere led. After a lesionectomy with resection of epileptic regions (performed with electrocorticographical guidance), the patient has been seizure-free for 4 years. Pathology confirmed a low-grade mixed glioma and cortical dysgenesis.


CONCLUSIONS
The coherence analysis demonstrated a pathway of secondary generalization, confirming that the lesional side was leading during ictal generalized discharges in flexor spasms.
Otsubo
H
H
Department of Neurology, The Hospital for Sick Children, University of Toronto, ON, Canada. hiroshi.otsubo@mailhub.sickkids.on.ca
Steinlin
M
M
Shirasawa
A
A
Hwang
P A
PA
Munn
R
R
Jay
V
V
Hoffman
H J
HJ
D001921:Brain / Q000503:physiopathology*; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods*; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D013036:Spasms, Infantile / Q000503:physiopathology*; D013997:Time Factors