John Libbey Eurotext

Gelastic seizures with dancing arising from the anterior prefrontal cortex Volume 16, numéro 2, June 2014


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1 Division of Pediatric Neurology, Dept. of Pediatrics, University of Alberta, Edmonton Clinic Health Academy
2 Dept. of Psychiatry, University of Alberta, Walter Mackenzie Health Sciences Centre, University of Alberta
3 Dept. of Surgery, Department of Surgery, 2D Walter C Mackenzie Health Sciences Centre, University of Alberta, Edmonton, Alberta, Canada
* Correspondence: Richard Tang-Wai Division of Pediatric Neurology, Dept. of Pediatrics,University of Alberta. Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta, T6T 1C9, Canada

Aim.This case report provides insight into the function of the anterior prefrontal cortex (aPFC), specifically Brodmann Area 10 (BA10), and its interconnectivity. Method. We present a 10-year-old patient with lesional epilepsy and ictal onset, localised to BA10 in the aPFC. Results. Thirty-four seizures were recorded. All seizures involved a demonstration of elation with laughter that was associated with a variety of different patterns of complex motor behaviour that included performing specific celebratory movements and acting out a Michael Jackson dance move. Electrographically, the seizures were all stereotyped and arose from the right frontal region, followed by a distinct left temporal ictal rhythm that corresponded with the onset of the behaviours. The lesion in the right aPFC was identified as a mixed lesion with both dysembryoplastic neuroepithelial tumour cells and type II cortical dysplasia. Conclusion.The electrographic analysis and unique seizure semiology suggest a connection between the aPFC and the contralateral temporal lobe. This neural pathway appears to be involved in the activation of previously formed procedural memories, creating an intensely positive emotional experience.