title: Ictal video-polygraphic features of perioral myoclonia with absences.
abstract: There have been few case reports of perioral myoclonia with absences (POMA) because of the lack of video-polygraphic recordings clarifying the electroencephalogram (EEG)-electromyogram (EMG) correlations. We describe one of the first video-polygraphic studies of POMA in a patient who underwent repeated and prolonged split-screen video-polygraphic recordings. The ictal EEG showed generalized and irregular discharges of spikes or multiple spikes and slow waves, while two concomitant EMG patterns appeared: (1) a rhythmic enhancement of the orbicularis oris and masseter muscles on both sides with minimal asymmetry corresponding to perioral movements, and (2) a progressive increment in muscular tone in the mylohyoideus muscle corresponding to oroalimentary automatisms. Myoclonic jerks were inconstantly time-locked to the spike component of the spike-wave complex. The evidence of a complex pattern of activation of the facial muscles suggests that the involvement of subcortical central pattern generators, related to masticatory activity, through the disinhibitory effect of the spike-wave discharge is a possible pathophysiological mechanism underlying POMA.
authors.affiliation: Epilepsy Center-Clinic of Nervous System Diseases, University of Foggia, Riuniti Hospital, Foggia, Italy. giudorsi@yahoo.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: d'Orsi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Demaio
authors.forename: Marina
authors.initials: M
authors.lastname: Trivisano
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Pascarella
authors.forename: Luigi M
authors.initials: LM
authors.lastname: Specchio
mesh_terms: D004569:Electroencephalography / Q000379:methods*; D004576:Electromyography / Q000379:methods*; D004831:Epilepsies, Myoclonic / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014743:Videotape Recording / Q000379:methods*