Epilepsia partialis continua as an isolated manifestation of motor cortical dysplasia.
Cortical dysplasia has been increasingly recognized as a cause of epilepsy. We describe herein a 31-year-old female patient with epilepsia partialis continua (EPC) in the right extremities, which had lasted for 15 years without generalized seizures and other neurological deteriorations. MRI showed a focal thickening around the left motor area, indicative of cortical dysplasia, with adjacent subcortical abnormal T2 high intensity, suggestive of dysmyelination. Transcranial magnetic stimulation revealed low motor thresholds and markedly prolonged latencies of motor-evoked potentials (MEP) of the affected side, consistent with hyperexcitability of the cortical motoneurons accompanied by dysmyelination. This case demonstrates that motor cortex dysplasia can result in a mild and non-progressive form of epilepsia partialis continua, associated with the characteristic MRI and MEP abnormalities.
Department of Neurology, Chiba University School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba 260-8670, Japan. sonoko.m@mb.infoweb.ne.jp
Sonoko
S
Misawa
Satoshi
S
Kuwabara
Shigeki
S
Hirano
Kazumoto
K
Shibuya
Kimihito
K
Arai
Takamichi
T
Hattori
D000328:Adult; D001927:Brain Diseases / Q000473:pathology / Q000503:physiopathology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000473:pathology; D004569:Electroencephalography / Q000379:methods; D004576:Electromyography / Q000379:methods; D017036:Epilepsia Partialis Continua / Q000209:etiology* / Q000473:pathology; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009044:Motor Cortex / Q000473:pathology / Q000503:physiopathology*