A clinical and magnetoencephalography study of MRI-negative startle epilepsy.
OBJECTIVE
The goal of this study was to investigate clinical findings, ictal semiology, and results of video/electroencephalography (video/EEG), and magnetoencephalography (MEG) in patients with startle epilepsy and normal brain MRI.


METHODS
Four patients (mean age 12.5 years) with startle epilepsy were investigated with MRI, video/EEG, and MEG.


RESULTS
Epilepsy diagnosis was established in childhood, and all had spontaneous and reflex seizures. Reflex seizures were triggered by sudden, unexpected sounds and tactile stimuli. The neurological examinations and MRIs were normal. MEG recordings showed focal epileptiform activity. An ictal MEG was obtained in one patient. Source modeling yielded dipole sources in right central frontal region.


CONCLUSIONS
The present study demonstrates that the origin of epileptiform activity in startle epilepsy can be localized in brain areas associated with supplementary motor seizures, even in patients with normal brain MRI. MEG adds complementary information to the localization of epileptiform activity and can be useful in planning invasive studies in cases evaluated for epilepsy surgery.
García-Morales
Irene
I
Epilepsy Unit, Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain. garciamorales2@gmail.com
Maestú
Fernando
F
Pérez-Jiménez
María Angeles
MA
Elices
Eloy
E
Ortiz
Tomás
T
Alvarez-Linera
Juan
J
Gil-Nagel
Antonio
A
D000293:Adolescent; D002540:Cerebral Cortex / Q000503:physiopathology; D002648:Child; D004569:Electroencephalography; D004574:Electromagnetic Fields; D020195:Epilepsy, Reflex / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography; D008297:Male; D012640:Seizures / Q000503:physiopathology; D055815:Young Adult