Article Text

other Versions

PDF
Reading epilepsy from the dominant temporo-occipital region.
  1. martine Gavaret (martine.gavaret{at}ap-hm.fr)
  1. Service de neurophysiologie clinique, Hôpital de la Timone, APHM, Marseille, France
    1. eric Guedj
    1. Service de Médecine Nucléaire, Hopital de la Timone, APHM, Marseille, France
      1. laurent Koessler
      1. Centre de Recherche en Automatique (CRAN), CNRS UMR 7039, Nancy, France
        1. Agnès Trebuchon-Da Fonseca
        1. Service de Neurophysiologie clinique, Hôpital de la Timone, APHM, Marseille, France
          1. Sandrine Aubert
          1. Service de neurophysiologie clinique, Hôpital de la Timone, APHM, Marseille, France
            1. Olivier Mundler
            1. Service de médecine nucléaire, Hôpital de la Timone, APHM, Marseille, France
              1. Patrick Chauvel
              1. Service de neurophysiologie clinique, Hôpital de la Timone, APHM, Marseille, France
                1. Fabrice Bartolomei
                1. Service de neurophysiologie clinique, Hôpital de la Timone, APHM, Marseille, France

                  Abstract

                  Reading epilepsy is a rare form of epilepsy, classified among idiopathic, age- and localisation-related (partial) epilepsies as a reflex epilepsy syndrome. Seizures usually consist of myoclonic jerks restricted to the jaw. However, distinct ictal features including visual symptoms and paroxysmal a- or dyslexia are described in some patients. The anatomical substrate of ictogenesis in reading epilepsy remains poorly understood.

                  We report here the case of a primary reading epilepsy for which ictal semiology was characterized by visual symptoms and dyslexia, investigated by MRI, interictal high-resolution EEG and PET, ictal video-EEG and SPECT. Brain MRI was normal. Interictal high resolution EEG was performed with 64 scalp channels, a realistic head model and different algorithms to solve the inverse problem. Interictal source localizations highlighted the left occipito-temporal junction. Interictal PET demonstrated bilateral occipito-temporal hypometabolism with left-sided predominance. Ictal EEG showed a rhythmic discharge in left temporo-parieto-occipital junction channels, with left occipito-temporal predominance. MRI fusion of the co-registered subtraction between ictal and interictal SPECT individualized relative hyperperfusion affecting (a) the left occipito-parietal junction area (b) the left lateral middle and inferior temporal gyri and (c) the left inferior frontal area.

                  Besides reading-induced myoclonic jerks of the jaw, a second variant of reading epilepsy exists with clearly partial seizures manifested by visual symptoms and a- or dyslexia. These seizures originate from the occipito-temporal region of the dominant hemisphere, corresponding to the posterior part of the neural network that underlies the function of reading.

                  Statistics from Altmetric.com

                  Request permissions

                  If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

                  Linked Articles