J Clin Neurol.  2006 Dec;2(4):272-275. 10.3988/jcn.2006.2.4.272.

Unilateral Epileptic Negative Myoclonus Following Focal Lesion of the Postcentral Cerebral Cortex Due to Acute Middle Cerebral Infarction

• Song IU
• Lee DG
• Kim JS
• An JY
• Lee SB
• Kim YI
• Lee KS

• KMID: 1980469
• DOI: http://doi.org/10.3988/jcn.2006.2.4.272

Abstract

Here we report a patient who suffered an acute infarction of the contralateral postcentral cerebral cortex and subsequently developed unilateral partial epilepsy with negative myoclonus. The findings of brain magnetic resonance imaging, polygraphic recordings of the postcentral somatosensory area, and response to anticonvulsant treatment support the presence of a cause-and-effect relationship, thereby providing evidence for a pathophysiological substrate for epileptic negative myoclonus.

Keyword

Epileptic negative myoclonus; Postcentral cerebral cortex; Cerebral infarction

MeSH Terms

Brain
Cerebral Cortex*
Cerebral Infarction*
Epilepsies, Partial
Humans
Infarction
Magnetic Resonance Imaging
Myoclonus*

Figure

• 

  Figure 1 Brain MRI showing acute ischemic changes in the inferior branch territory of the right middle cerebral artery, involving the parietotemporal region (postcentral cerebral cortex).

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  Figure 2 EMG silent periods lasting up to about 400 ms appear irregularly, interrupting the ongoing interferential recorded from the left extensor muscle. The silent periods are time-locked with the epileptic discharges recorded from the contralateral parietotemporal region.

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  Figure 3 Combined EMG and EEG polygraphic recordings made after the patient's antiepileptic agents were adjusted. The continuous muscle contractions without silent periods are evident; the EEG also shows only mixed slowing waves without epileptic discharges on the right parietotemporal region.

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