TY  - JOUR
AV  - public
SP  - 503 
N2  - A 28-year-old patient with pharmacoresistant non-lesional right frontal epilepsy underwent extra-operative intracranial EEG recordings and electrical cortical stimulation (ECS) to map eloquent cortex. Right supplementary motor area (SMA) ECS induced a brief seizure with habitual symptoms involving neck tingling followed by asymmetric tonic posturing. An additional feature was neck atonia. During atonia and sensory aura, discharges were seen in the mesial frontal electrodes and precentral gyrus. Besides motor signs, atonia, although rare and not described in the neck muscles, and sensations have been reported with SMA stimulation. The mechanisms underlying neck atonia in seizures arising from the SMA can be explained by supplementary negative motor area (SNMA) - though this was not mapped in electrodes overlying the ictal onset zone in our patient - or primary sensorimotor cortex activation through rapid propagation. Given the broad spectrum of signs elicited by SMA stimulation and rapid spread of seizures arising from the SMA, caution should be taken to not diagnose these as non-epileptic, as had previously occurred in this patient.
SN  - 1525-5050
JF  - Epilepsy & Behavior
N1  - This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
UR  - http://dx.doi.org/10.1016/j.yebeh.2012.05.012
ID  - discovery1366964
IS  - 4
EP  -  506
KW  - Adult
KW  -  Brain Mapping
KW  -  Electric Stimulation
KW  -  Electroencephalography
KW  -  Female
KW  -  Humans
KW  -  Magnetic Resonance Imaging
KW  -  Motor Cortex
KW  -  Neck Muscles
KW  -  Seizures
A1  - Kovac, S
A1  - Nachev, P
A1  - Rodionov, R
A1  - Scott, C
A1  - McEvoy, AW
A1  - Toms, N
A1  - Wehner, T
A1  - Duncan, JS
A1  - Diehl, B
VL  - 24
TI  - Neck atonia with a focal stimulation-induced seizure arising from the SMA: pathophysiological considerations.
Y1  - 2012/06/30/
ER  -