Tooth-Brushing Epilepsy: A Report of a Case with Structural and Functional Imaging and Electrophysiology Demonstrating a Right Frontal Focus |
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| Authors: | Terence J. O'Brien,Robert E. Hogan&dagger ,Leslie Sedal,Vanessa Murrie&Dagger ,Mark J. Cook&dagger &Dagger |
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| Affiliation: | Department of Clinical Neurosciences, St. Vincent's, Victoria, Australia;Department of Royal Melbourne Hospitals, Victoria, Australia;The Australian Computing and Communications Institute, Victoria, Australia |
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| Abstract: | Summary: Patients with reflex epilepsies may provide insights into cerebral pathophysiology. We report a patient with an unusual form of reflex epilepsy in whom seizures are induced by tooth brushing. Magnetic resonance imaging (MRI) demonstrated a right posterior frontal low-grade tumor predominantly involving the precentral gyrus. Video-telemetry demonstrated right-sided epileptiform activity during a typical induced complex partial seizure. An ictal single photon emission computed tomography (SPECT) scan showed an area of hyperfusion that corresponded to the MRI lesion on coregistration with a surface-matching technique. A subsequent coregistered interictal SPECT scan demonstrated hypoperfusion in the same region. Ours is the first report to demonstrate a structural focus in this unusual form of reflex epilepsy. Possible mechanisms to explain the induction of the seizures are discussed. |
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| Keywords: | Reflex epilepsy Cerebral pathophysiology Complex partial seizures Tooth brushing |
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