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Ictal kissing with subdural EEG recording.

Alsemari A, Alotaibi F, Baz S - Epilepsy Behav Case Rep (2013)

Bottom Line: Magnetic resonance imaging of the brain showed right small cortical and subcortical lesions of the right inferior frontal lobe with gliosis but without mass effect and normal-sized hippocampi.The patient continued to be seizure-free for one year postoperatively.However, the affectionate kissing behavior was associated with spread of the epileptic discharges to the right frontal lobe.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.

ABSTRACT

Purpose: Ictal kissing has been described in the literature. Five cases were reported and associated with temporal lobe epilepsy lateralizing to the nondominant hemisphere.

Methods: A case of ictal kissing was identified. The aim was to demonstrate the clinical, clinical and electrophysiological features (as recorded by subdural electrodes). The surgical procedure, histopathology, and imaging data were reviewed and correlated with the literature.

Results: A 29-year-old right-handed female, who presented with ictal right hand left arm dystonic posturing, and lip smacking, was studied. The automatism was usually followed by prolonged emotional gestures and by hugging and kissing her relative and/or attendant nurse. Magnetic resonance imaging of the brain showed right small cortical and subcortical lesions of the right inferior frontal lobe with gliosis but without mass effect and normal-sized hippocampi. The PET scan showed hypometabolism of the right temporal lobe. Neuropsychological evaluation showed deficit in her nonverbal memory. The subdural electrodes showed high amplitude spikes over right mesial temporal lobe strips. The offsite of the ictal discharges was usually at the right frontal strips. Right standard temporal lobectomy with amygdalohippocampectomy and right inferior frontal lesionectomy were performed. The patient continued to be seizure-free for one year postoperatively.

Conclusion: Our case report supports with subdural EEG recording the findings of the few reported cases of ictal kissing behavior lateralized to the nondominant hemisphere. However, the affectionate kissing behavior was associated with spread of the epileptic discharges to the right frontal lobe.

No MeSH data available.


Related in: MedlinePlus

Surface ictal EEG onset shows rhythmic slow waves over the right frontotemporal areas.
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f0005: Surface ictal EEG onset shows rhythmic slow waves over the right frontotemporal areas.

Mentions: A 29-year-old right-handed female, who has a history of epilepsy for the last 10 years, was studied. The patient has no history of febrile convulsions. She has a history of an aura of fear followed by automatism consisting of right hand left upper limb dystonic posturing, and lip smacking. The automatism was usually followed by prolonged emotional gestures, hugging and kissing her relative and/or attendant nurse. The patient's seizure frequency varied from 1 to 2 per month. Magnetic resonance imaging of the brain showed small cortical and subcortical lesions of the right inferior frontal lobe without mass effect or enhancement. The lesion was located directly anterior of the insular gyrus and inferior to the inferior frontal gyrus (Fig. 7). The hippocampi looked symmetrical (Fig. 8). The PET scan showed hypometabolism of the right temporal lobe (Fig. 9). Neuropsychological evaluation showed deficit in her nonverbal memory. The surface EEG showed right frontotemporal rhythmic slow wave activity (Fig. 1). Because of the uncertainty of the surface ictal EEG onset, the right inferior frontal lesion, and the normal-sized and symmetrical hippocampi, subdural EEG recording strips were done, covering the right temporal lobe and the right inferior frontal prelesional regions.


Ictal kissing with subdural EEG recording.

Alsemari A, Alotaibi F, Baz S - Epilepsy Behav Case Rep (2013)

Surface ictal EEG onset shows rhythmic slow waves over the right frontotemporal areas.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4150642&req=5

f0005: Surface ictal EEG onset shows rhythmic slow waves over the right frontotemporal areas.
Mentions: A 29-year-old right-handed female, who has a history of epilepsy for the last 10 years, was studied. The patient has no history of febrile convulsions. She has a history of an aura of fear followed by automatism consisting of right hand left upper limb dystonic posturing, and lip smacking. The automatism was usually followed by prolonged emotional gestures, hugging and kissing her relative and/or attendant nurse. The patient's seizure frequency varied from 1 to 2 per month. Magnetic resonance imaging of the brain showed small cortical and subcortical lesions of the right inferior frontal lobe without mass effect or enhancement. The lesion was located directly anterior of the insular gyrus and inferior to the inferior frontal gyrus (Fig. 7). The hippocampi looked symmetrical (Fig. 8). The PET scan showed hypometabolism of the right temporal lobe (Fig. 9). Neuropsychological evaluation showed deficit in her nonverbal memory. The surface EEG showed right frontotemporal rhythmic slow wave activity (Fig. 1). Because of the uncertainty of the surface ictal EEG onset, the right inferior frontal lesion, and the normal-sized and symmetrical hippocampi, subdural EEG recording strips were done, covering the right temporal lobe and the right inferior frontal prelesional regions.

Bottom Line: Magnetic resonance imaging of the brain showed right small cortical and subcortical lesions of the right inferior frontal lobe with gliosis but without mass effect and normal-sized hippocampi.The patient continued to be seizure-free for one year postoperatively.However, the affectionate kissing behavior was associated with spread of the epileptic discharges to the right frontal lobe.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.

ABSTRACT

Purpose: Ictal kissing has been described in the literature. Five cases were reported and associated with temporal lobe epilepsy lateralizing to the nondominant hemisphere.

Methods: A case of ictal kissing was identified. The aim was to demonstrate the clinical, clinical and electrophysiological features (as recorded by subdural electrodes). The surgical procedure, histopathology, and imaging data were reviewed and correlated with the literature.

Results: A 29-year-old right-handed female, who presented with ictal right hand left arm dystonic posturing, and lip smacking, was studied. The automatism was usually followed by prolonged emotional gestures and by hugging and kissing her relative and/or attendant nurse. Magnetic resonance imaging of the brain showed right small cortical and subcortical lesions of the right inferior frontal lobe with gliosis but without mass effect and normal-sized hippocampi. The PET scan showed hypometabolism of the right temporal lobe. Neuropsychological evaluation showed deficit in her nonverbal memory. The subdural electrodes showed high amplitude spikes over right mesial temporal lobe strips. The offsite of the ictal discharges was usually at the right frontal strips. Right standard temporal lobectomy with amygdalohippocampectomy and right inferior frontal lesionectomy were performed. The patient continued to be seizure-free for one year postoperatively.

Conclusion: Our case report supports with subdural EEG recording the findings of the few reported cases of ictal kissing behavior lateralized to the nondominant hemisphere. However, the affectionate kissing behavior was associated with spread of the epileptic discharges to the right frontal lobe.

No MeSH data available.


Related in: MedlinePlus