Oroalimentary automatisms induced by electrical stimulation of the fronto-opercular cortex in a patient without automotor seizures.
Despite being a common sign in focal epilepsies, the exact symptomatogenic zone for oroalimentary automatisms remains largely unknown. We describe a patient with refractory complex partial seizures secondary to a right temporoparietal malformation of cortical development who underwent prolonged video/EEG monitoring with subdural electrodes. During his typical seizures, the patient manifested decreased awareness but never automatisms. However, during electrical cortical stimulation of two electrodes located over the right inferior frontal gyrus, oroalimentary automatisms with preserved consciousness were elicited, with no afterdischarges detected in the adjacent electrodes. These two electrodes were distant from the seizure onset zone and were not involved in seizure propagation. This case provides evidence that fronto-opercular cortex may be involved in the generation of oroalimentary automatisms.
Maestro
Iratxe
I
Epilepsy Unit, Neurology Department, Hospital Clínic, Barcelona, Spain.
Carreño
Mar
M
Donaire
Antonio
A
Rumià
Jordi
J
Conesa
Gerardo
G
Bargalló
Nuria
N
Falcón
Carlos
C
Setoain
Xavier
X
Pintor
Luis
L
Boget
Teresa
T
D000328:Adult; D001332:Automatism / Q000503:physiopathology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000502:physiology; D003243:Consciousness / Q000502:physiology; D003679:Deglutition / Q000502:physiology*; D004292:Dominance, Cerebral / Q000502:physiology; D004558:Electric Stimulation; D004569:Electroencephalography; D017034:Epilepsy, Frontal Lobe / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008409:Mastication / Q000502:physiology*; D010296:Parietal Lobe / Q000503:physiopathology; D014741:Video Recording