Musicogenic seizures can arise from multiple temporal lobe foci: intracranial EEG analyses of three patients.
OBJECTIVE
To determine the ictal-onset zone of musicogenic seizures by using intracranial EEG monitoring.


METHODS
Musicogenic seizures in three patients with medically intractable musicogenic epilepsy were first localized by using noninvasive methods including, in one patient, ictal magnetoencephalography (MEG) and magnetic resonance spectroscopy (MRS). The ictal-onset zones in these patients were then further localized using by intracranial EEG monitoring, and the outcomes of the two patients who underwent epilepsy surgery were determined.


RESULTS
Patient 1's musicogenic seizures localized to the right lateral temporal lobe, patient 2's originated in the right mesial temporal lobe, and patient 3's arose independently from both mesial temporal lobes. Patients 1 and 2 underwent resective epilepsy surgery and are seizure free (Engel class I).


CONCLUSIONS
Musicogenic epilepsy is a heterogeneous syndrome with seizures that can arise from multiple temporal lobe foci. Patients with medically intractable musicogenic epilepsy and with unilateral ictal onset zones may be considered candidates for resective epilepsy surgery.
Tayah
Tania F
TF
Department of Neurology, Vanderbilt University, Nashville, Tennessee 37232-8552, USA.
Abou-Khalil
Bassel
B
Gilliam
Frank G
FG
Knowlton
Robert C
RC
Wushensky
Curtis A
CA
Gallagher
Martin J
MJ
D000328:Adult; D038481:Anterior Temporal Lobectomy; D001931:Brain Mapping; D018572:Disease-Free Survival; D004567:Electrodes, Implanted; D004569:Electroencephalography / Q000379:methods / Q000706:statistics & numerical data*; D020195:Epilepsy, Reflex / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D015225:Magnetoencephalography; D008991:Monitoring, Physiologic; D011300:Preoperative Care; D013702:Temporal Lobe / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome