TY  - JOUR
KW  - atonic seizure
KW  -  hiccups
KW  -  seizure
KW  -  trisomy 4p
A1  - Varley, J
A1  - Wehner, T
A1  - Sisodiya, S
EP  - 477
IS  - 4
Y1  - 2015/12//
TI  - Diaphragm myoclonus followed by generalised atonia in a patient with trisomy 4p: unusual semiology in an unusual condition.
VL  - 17
N2  - In this report, we describe a female patient with trisomy 4p, a rare genetic condition, with unusual seizure semiology. The patient is one of the oldest reported survivors with this condition. This semiology was noted while she was being monitored by inpatient video telemetry. We observed a series of myoclonic shoulder jerks, followed by hiccup-like episodes, and finally an atonic head drop. Corresponding ictal EEG showed semi-rhythmic high-amplitude slow waves with spikes superimposed over the frontotemporal areas. This semiology was confirmed as habitual by her parents. Subsequent hiccup-like episodes had no EEG correlate, and the head drop was again associated with semi-rhythmic high-amplitude slow waves and superimposed spikes, more prominent over the right hemisphere. In addition, we review the several cases in which hiccups have been associated with seizures and how this may relate to the neural pathways involved in the pathophysiology of hiccups. We believe the ictal hiccup-like episodes followed by atonia to be a seizure semiology that has not previously been documented.
SN  - 1950-6945
SP  - 473
AV  - public
UR  - http://dx.doi.org/ 10.1684/epd.2015.0787
ID  - discovery1482618
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
JF  - Epileptic Disord
ER  -