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Epileptic Disorders

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Frontal lobe epilepsy with atypical seizure semiology resembling shuddering attacks or wet dog shake seizures Volume 14, numéro 1, March 2012

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  • Frontal lobe epilepsy with atypical seizure semiology resembling shuddering attacks or wet dog shake seizures

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Auteurs
Department of Pediatric Neurology,, Department of Radiology,, Department of Pathology, Molecular Medicine,, Department of Neurosurgery, Charles University, Second Medical School, Motol Hospital, Prague, Czech Republic

We report a girl with a drug-resistant frontal lobe epilepsy caused by focal cortical dysplasia, who exhibited uncommon seizures. The seizures consisted of shoulder or whole body shuddering after a short psychic aura and face grimacing. Consciousness was fully preserved. The seizures resembled “wet dog shake” seizures described in rat models of epilepsy or shuddering attacks in infants. EEG findings were inconclusive, however, MRI showed a clear dysplastic lesion in the right frontal mesial and polar structures. The patient underwent an extended lesionectomy guided by neuronavigation and intraoperative electrocorticography. Focal cortical dysplasia type Ib was histologically confirmed and the patient has been seizure-free for the three years following resection. [ Published with video sequences]