title: Reflex Seizures Triggered by Exposure to Characters With Numerical Value: A Case With Right Temporal Cortical Dysplasia.
abstract: Reflex seizures can be triggered by a variety of stimuli. We present a case with drug-resistant complex partial seizures originating in right temporal lobe triggered extensively by visual, auditory, and mental exposure to multidigit numbers. The patient was investigated in video-EEG monitoring unit and seizures were triggered by numerical stimuli. Scalp EEG findings suggested a right temporal focus but ictal semiological findings suspicious for an extratemporal area necessitated the invasive EEG study. A right anterior temporal seizure focus was established with invasive monitoring and cortical stimulation studies. Magnetic resonance imaging showed a cortical dysplasia in right anterior temporal lobe and ictal single-photon emission computed tomography confirmed the epileptogenic focus, leading to a right temporal lobectomy and amygdalohippocampectomy and a pathological diagnosis of focal cortical dysplasia type Ia. The patient is seizure-free at the end of the second postoperative year despite repeated exposures to numbers. To our knowledge, this is the first report of seizures triggered by numbers. It is also of particular importance as the reflex seizures are associated with a cortical lesion and it may suggest involvement of right anterior temporal lobe in numerical processing.
authors.affiliation: Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Şefik Evren
authors.initials: ŞE
authors.lastname: Erdener
authors.affiliation: Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey irseltezer@yahoo.com.tr.
authors.forename: F Irsel
authors.initials: FI
authors.lastname: Tezer
authors.affiliation: Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Kader K
authors.initials: KK
authors.lastname: Oğuz
authors.affiliation: Department of Neurology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Özden
authors.initials: Ö
authors.lastname: Kamışlı
authors.affiliation: Department of Nuclear Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Eser Lay
authors.initials: EL
authors.lastname: Ergün
authors.affiliation: Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Figen
authors.initials: F
authors.lastname: Söylemezoğlu
authors.affiliation: Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Serap
authors.initials: S
authors.lastname: Saygi
mesh_terms: D000328:Adult; D004569:Electroencephalography / Q000379:methods; D020195:Epilepsy, Reflex / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D054220:Malformations of Cortical Development / Q000175:diagnosis*; D055641:Mathematical Concepts; D013561:Symbolism; D013702:Temporal Lobe / Q000002:abnormalities* / Q000000981:diagnostic imaging*
keywords: cortical dysplasia; numbers; reflex seizures; temporal lobe; video-EEG monitoring