John Libbey Eurotext

Successful epilepsy surgery in frontal lobe epilepsy with startle seizures: a SEEG studyFrontal epilepsy with startle seizures Volume 17, issue 4, December 2015


  • Successful epilepsy surgery in frontal lobe epilepsy with startle seizures: a SEEG study


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1 Neurology, Neurovascular Diseases National Institute, Bucharest, Romania
2 Neurology Department, University Emergency Hospital, Bucharest, Romania
3 Physics Department, University of Bucharest, Bucharest, Romania
4 FHC Inc, Bowdoin ME, USA
5 Neurosurgery Department, Bagdasar-Arseni Hospital, Bucharest, Romania
6 Department of Physiology & Pharmacology, Wake Forest University Health Sciences, Winston-Salem, NC, USA
7 Neurology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
* Correspondence: Irina Popa Epilepsy Monitoring Unit, Neurology Department, University Emergency Hospital, 169 Splaiul Independentei Street, 050098 Bucharest, Romania
  • Key words: startle epilepsy, mesial fronto-parietal network, SEEG, focal cortical dysplasia
  • DOI : 10.1684/epd.2015.0790
  • Page(s) : 363-71
  • Published in: 2015

Pre-surgical assessment and surgical management of frontal epilepsy with normal MRI is often challenging. We present a case of a 33-year-old, right-handed, educated male. During childhood, his seizures presented with mandibular myoclonus and no particular trigger. As a young adult, he developed seizures with a startle component, triggered by unexpected noises. During his ictal episodes, he felt fear and grimaced with sudden head flexion and tonic axial posturing. Similar seizures also occurred without startle. Neuropsychological assessment showed executive dysfunction and verbal memory deficit. The cerebral MRI was normal. Electro-clinical reasoning, investigations performed, the results obtained and follow-up are discussed in detail. [Published with video sequence]