Motor cortical epilepsia partialis continua in a patient with a localized sensory cortical lesion.
We describe a 33-year-old man with cyclosporine encephalopathy who showed continuous jerking in the left upper limb due to epilepsia partialis continua. Jerk-locked back averaging (JLA) of magnetoencephalogram disclosed a spike preceding the jerk localized at the hand motor area, whereas JLA of electroencephalogram revealed no premyoclonus spikes. The paired-pulse motor cortical transcranial magnetic stimulation revealed motor cortical hyperexcitability, while the paired-pulse somatosensory evoked potential showed no sensory cortical hyperexcitability. The brain MRI showed a high intensity lesion localized at the hand sensory area. These results suggest that the jerks were produced by discharges at the motor cortex probably disinhibited by the sensory cortical lesion.
Nakatani-Enomoto
Setsu
S
Department of Neurology, Division of Neuroscience, Graduate school of Medicine, The University of Tokyo, Tokyo, Japan. setsu-tky@umin.ac.jp
Terao
Yasuo
Y
Hanajima
Ritsuko
R
Matsuda
Shunichi
S
Ohminami
Shinya
S
Inomata-Terada
Satomi
S
Matsumoto
Hideyuki
H
Yugeta
Akihiro
A
Yamamoto
Tomotaka
T
Goto
Jun
J
Yumoto
Masato
M
Tsuji
Shoji
S
Ugawa
Yoshikazu
Y
D000328:Adult; D001772:Blood Cell Count; D001927:Brain Diseases / Q000139:chemically induced / Q000473:pathology; D016572:Cyclosporine / Q000009:adverse effects; D004569:Electroencephalography; D004576:Electromyography; D017036:Epilepsia Partialis Continua / Q000473:pathology*; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D006225:Hand / Q000294:innervation; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography; D008297:Male; D009044:Motor Cortex / Q000473:pathology*; D013003:Somatosensory Cortex / Q000473:pathology*; D050781:Transcranial Magnetic Stimulation
D007166:Immunosuppressive Agents; D016572:Cyclosporine