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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.


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Ictal subdural EEG: more marked kissing behavior.
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f0025: Ictal subdural EEG: more marked kissing behavior.

Mentions: In the Epilepsy Unit, 5 push button events were recorded. The subdural electrodes showed clinical correlation of fear and palpitation with an onset of high amplitude spikes over right mesial temporal lobe strips (R-MT2, 4) (see arrow, Fig. 2). The manual automatism and lip smacking started at the appearance of the epileptic discharges at the anterior temporal strip (see arrow, Fig. 3). The emotional hugging and kissing behavior was correlated with the spread of the epileptic discharges in the frontal lobe (see arrow, Fig. 4) and (Fig. 5). The end of the kissing behavior was coupled to the offsite of the ictal discharge at the right frontal strips (see arrow, Fig. 6).


Ictal kissing with subdural EEG recording.

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

Ictal subdural EEG: more marked kissing behavior.
© Copyright Policy
Related In: Results  -  Collection

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

f0025: Ictal subdural EEG: more marked kissing behavior.
Mentions: In the Epilepsy Unit, 5 push button events were recorded. The subdural electrodes showed clinical correlation of fear and palpitation with an onset of high amplitude spikes over right mesial temporal lobe strips (R-MT2, 4) (see arrow, Fig. 2). The manual automatism and lip smacking started at the appearance of the epileptic discharges at the anterior temporal strip (see arrow, Fig. 3). The emotional hugging and kissing behavior was correlated with the spread of the epileptic discharges in the frontal lobe (see arrow, Fig. 4) and (Fig. 5). The end of the kissing behavior was coupled to the offsite of the ictal discharge at the right frontal strips (see arrow, Fig. 6).

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