Gelastic seizures with dancing arising from the anterior prefrontal cortex |
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| Authors: | John Neilson Tom Snyder Jeff Pugh Matt Wheatley Richard Tang‐Wai |
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| Affiliation: | 1. Division of Pediatric Neurology, Dept. of Pediatrics, University of Alberta, Edmonton Clinic Health Academy;2. Dept. of Psychiatry, University of Alberta, Walter Mackenzie Health Sciences Centre, University of Alberta;3. Dept. of Surgery, Department of Surgery, 2D Walter C Mackenzie Health Sciences Centre, University of Alberta, , Edmonton, Alberta, Canada |
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| Abstract: | Aim. This case report provides insight into the function of the anterior prefrontal cortex (aPFC), specifically Brodmann Area 10 (BA10), and its interconnectivity. Method. We present a 10‐year‐old patient with lesional epilepsy and ictal onset, localised to BA10 in the aPFC. Results. Thirty‐four seizures were recorded. All seizures involved a demonstration of elation with laughter that was associated with a variety of different patterns of complex motor behaviour that included performing specific celebratory movements and acting out a Michael Jackson dance move. Electrographically, the seizures were all stereotyped and arose from the right frontal region, followed by a distinct left temporal ictal rhythm that corresponded with the onset of the behaviours. The lesion in the right aPFC was identified as a mixed lesion with both dysembryoplastic neuroepithelial tumour cells and type II cortical dysplasia. Conclusion. The electrographic analysis and unique seizure semiology suggest a connection between the aPFC and the contralateral temporal lobe. This neural pathway appears to be involved in the activation of previously formed procedural memories, creating an intensely positive emotional experience. |
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| Keywords: | temporal lobe epilepsy gelastic seizures anterior prefrontal cortex Brodmann area 10 neural networks |
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