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Tooth-brushing epilepsy: an SEEG study and surgical treatment Volume 22, numéro 4, August 2020

TEST YOURSELF

(1) Neurological deficits associated with the resection of lesions within the facial motor area are usually transient. Explain why.

 

(2) In the semiological sequence of this patient`s seizures, left hemifacial contraction is immediately followed by extension of the arm. Explain anatomically the reason for this.

 

(3) What factors, pertaining to gingival stimulation, could induce reflex seizures in this case?

 

 

 

 

 

 

 

 

 

 

 

 

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Answers

(1) When considering surgery for lesions located in the face sensory and/or motor area, one must take into account that there are bilateral projection pathways of motor and trigeminal sensory information, from and to the cortex, and these have been identified in humans.

 

(2) The motor facial area is located, according to the disposition of the motor homunculus, immediately inferior to the hand and arm motor area. Thus, electrical propagation of a seizure from the facial area could secondarily compromise the upper limb motor area, as described for the “Jacksonian march”.

 

(3) Repetition of the stimulus, as well as frequency and intensity of the stimulus have been described as variables that could influence seizure induction.

 

 

 

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