title: Cephalic auras of supplementary motor area origin: an ictal MEG and SAM(g2) study.
abstract: Although a nonspecific cephalic sensation, the so-called "cephalic aura," is a common sensory aura, particularly in frontal lobe seizures, but is rarely is the entire sensory seizure event. The unusual presentation of cephalic sensations in isolation representing supplementary motor area (SMA) seizures, which are commonly unaccompanied by ictal electroencephalography (EEG) changes, can easily lead to misdiagnosis of nonepileptic psychogenic seizures. We illustrate the case of a 36-year-old male patient with frontal lobe epilepsy who presented with isolated cephalic auras described as a nonvertiginous sense of head movement without observable clinical signs after his habitual partial motor seizures were controlled with pharmacotherapy. Video/EEG recordings showed no recognizable epileptic discharges time-locked to the onset of the isolated cephalic auras. Ictal magnetoencephalography (MEG) with synthetic aperture magnetometry-kurtosis (SAM(g(2))) analysis demonstrated the SMA onset of the cephalic auras; thus, MEG was essential in differentiating these isolated auras from nonepileptic psychogenic events.
authors.affiliation: Department of Psychiatry, Osaka University Graduate School of Medicine, Suita City, Japan.
authors.forename: Leonides
authors.initials: L
authors.lastname: Canuet
authors.forename: Ryouhei
authors.initials: R
authors.lastname: Ishii
authors.forename: Masao
authors.initials: M
authors.lastname: Iwase
authors.forename: Ryu
authors.initials: R
authors.lastname: Kurimoto
authors.forename: Kouji
authors.initials: K
authors.lastname: Ikezawa
authors.forename: Michiyo
authors.initials: M
authors.lastname: Azechi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nakahachi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Takeda
mesh_terms: D000328:Adult; D001931:Brain Mapping; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000473:pathology / Q000503:physiopathology*; D005625:Frontal Lobe / Q000473:pathology; D019416:Head Movements / Q000502:physiology; D006801:Humans; D015225:Magnetoencephalography; D008297:Male; D009044:Motor Cortex / Q000503:physiopathology*