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Motor cortical epilepsia partialis continua in a patient with a localized sensory cortical lesion |
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| Authors: | Setsu Nakatani-Enomoto Yasuo Terao Ritsuko Hanajima Shunichi Matsuda Shinya Ohminami Satomi Inomata-Terada Hideyuki Matsumoto Akihiro Yugeta Tomotaka Yamamoto Jun Goto Masato Yumoto Shoji Tsuji Yoshikazu Ugawa |
| Institution: | aDepartment of Neurology, Division of Neuroscience, Graduate school of Medicine, The University of Tokyo, Tokyo, Japan;bDepartment of Clinical Laboratory, Graduate school of Medicine, The University of Tokyo, Tokyo, Japan;cDepartment of Neurology, School of Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima-city, Fukushima 960-1295, Japan |
| Abstract: | 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. |
| Keywords: | Epilepsia partialis continua Cyclosporine Jerk-locked back averaging Magnetoencephalography |
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