John Libbey Eurotext

Epileptic Disorders

The Educational Journal of the International League Against Epilepsy

Epilepsia partialis continua triggered by traumatic hand injury: a peripheral tuning of brain excitability? Volume 18, numéro 1, March 2016

Vidéos

  • Epilepsia partialis continua triggered by traumatic hand injury: a peripheral tuning of brain excitability?
  • Epilepsia partialis continua triggered by traumatic hand injury: a peripheral tuning of brain excitability?

Illustrations

  • Figure 1
  • Figure 2
Auteurs
1 Service of Neurosurgery, Hospital São Lucas, Porto Alegre
2 Department of Surgery, Faculty of Medicine, Porto Alegre
3 Porto Alegre Epilepsy Surgery Program, Hospital São Lucas
4 Service of Neurology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre
5 Departament of Epilepsy, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
6 Department of Pathology, Hospital São Lucas, Pontifícia Universidade Católica do Rio, Grande do Sul (PUCRS), Porto Alegre
7 Internal Medicine, Division of Neurology, Faculty of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
* Correspondence: Eliseu Paglioli Serviço de Neurocirurgia, Hospital São Lucas da PUCRS, Avenida Ipiranga 6690, CEP:90610-000, Porto Alegre, RS, Brazil
  • Mots-clés : epilepsia partialis continua, focal cortical dysplasia, peripheral injury, disinhibition, epilepsy surgery
  • DOI : 10.1684/epd.2016.0798
  • Page(s) : 13-8
  • Année de parution : 2016

Epilepsia partialis continua is often refractory to antiepileptic medication and its causal relation to peripheral sensory stimuli has only rarely been suggested. We report a man who received surgery for temporal lobe epilepsy 10 years ago, who presented “de novo” epilepsia partialis continua following mild traumatic injury of the left hand. Continuous myoclonus of the left upper limb started the day after injury and persisted unabated for several weeks. Non-invasive evaluation was inconclusive. Acute electrocorticography during surgery under local anaesthesia revealed continuous, rhythmic spiking over the right sensorimotor cortex. Tailored excision of the posterior bank of the motor and adjacent sensory cortex immediately stopped the continuous myoclonus. Histopathology showed abnormal radial lamination and was compatible with focal cortical dysplasia type IA. Epilepsia partialis continua did not recur for seven years. Afferent stimuli from peripheral injury can disinhibit hyperexcitable sensorimotor cortex leading to epilepsia partialis continua. [Published with video sequences online]