title: Restricted frontomesial epileptogenic focus generating dyskinetic behavior and laughter.
abstract: OBJECTIVE
  Substantial data are missing about the anatomic location of frontal regions supporting gelastic seizures.
  
  
  METHODS
  We report the results of stereo-electro-encephalographic 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Service de Neurologie, Neuropsychologie et explorations fonctionnelles des épilepsies, hospices civils de Strasbourg, Strasbourg, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Chassagnon
authors.forename: Lorella
authors.initials: L
authors.lastname: Minotti
authors.forename: Stephane
authors.initials: S
authors.lastname: Kremer
authors.forename: Laurent
authors.initials: L
authors.lastname: Verceuil
authors.forename: Dominique
authors.initials: D
authors.lastname: Hoffmann
authors.forename: Alim Louis
authors.initials: AL
authors.lastname: Benabid
authors.forename: Philippe
authors.initials: P
authors.lastname: Kahane
mesh_terms: D000328:Adult; D001479:Basal Ganglia / Q000503:physiopathology; D020820:Dyskinesias / Q000175:diagnosis* / Q000503:physiopathology; D004567:Electrodes, Implanted; D004569:Electroencephalography / Q000379:methods* / Q000706:statistics & numerical data; D017034:Epilepsy, Frontal Lobe / Q000175:diagnosis* / Q000503:physiopathology; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000503:physiopathology*; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D007845:Laughter / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009044:Motor Cortex / Q000503:physiopathology; D013238:Stereotaxic Techniques