Prolonged focal negative motor seizures: a video-EEG study.
OBJECTIVE
Focal negative motor (akinetic) seizures are rare ictal events that are diagnostically challenging because they are difficult to differentiate from postictal Todd paresis, transient ischemic attacks, migraine events, and psychogenic episodes.


METHODS
We describe a 45-year-old man in whom, after surgical drainage of a right frontoparietal subdural hematoma, prolonged episodes developed with flaccid paralysis of the left arm.


RESULTS
A video-EEG recording demonstrated a close relation between the focal motor impairment and a clear-cut epileptic ictal discharge involving the right perirolandic cortical areas.


CONCLUSIONS
On the basis of the electroclinical data, we hypothesize the involvement of the primary motor area in the genesis of the epileptic discharge triggering focal negative seizures.
Villani
Flavio
F
Division of Clinical Epileptology, Instituto Nazionale Neurologico "C. Besta", Milan, Italy. fvillani@istituto-besta.it
D'Amico
Domenico
D
Pincherle
Alessandro
A
Tullo
Vincenzo
V
Chiapparini
Luisa
L
Bussone
Gennaro
G
D001931:Brain Mapping; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000379:methods / Q000706:statistics & numerical data*; D020938:Epilepsy, Partial, Motor / Q000175:diagnosis* / Q000503:physiopathology; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D010291:Paresis / Q000175:diagnosis / Q000503:physiopathology; D013997:Time Factors; D014743:Videotape Recording