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Reflex Epilepsy Provoked by Mental Activities Mainly Associated with Use of the Hands
오영미, 서정화, 천상명, 김상호,
소속 상세정보
오영미 ( Oh Young-Mi )
동아대학교 의과대학 신경과학교실
서정화 ( Seo Jeong-Hwa )
동아대학교 의과대학 신경과학교실
천상명 ( Cheon Sang-Myung )
동아대학교 의과대학 신경과학교실
김상호 ( Kim Sang-Ho )
동아대학교 의과대학 신경과학교실
KMID : 0877220040080020155
Abstract
There have been very few reports on reflex seizures induced by writing. Complex precipitating behaviors such as calculation, writing, copying of complicated figure, and spatial construction have been recognized as triggering factor of epileptic seizures. We report a case of a patient with a very unusual form of complex reflex epilepsy in which seizures are usually induced by writing or spatial construction. Neurological examination was normal and brain magnetic resonance imaging showed mild brain atrophy without focal lesion. During long-term video-EEG monitoring, she was instructed to write a letter with the right hand. About 20 minutes after writing, she experienced similar aura and motion arrest and then showed an elevation of bilateral upper extremities like myoclonic jerk followed by generalized tonic clonic seizure. On ictal EEG, spike and wave complexes appeared from both centroparietal region followed by 10 Hz rhythmic activities for 20 seconds. Interictal EEG was normal. Ictal-interictal subtraction image of brain SPECT (99mTc-HMPAO) showed hyperperfusion in the middle frontal gyrus and precentral gyrus of left frontal lobe and superior and inferior frontal gyrus of right frontal lobe. We suggest that this reflex epilepsy might be originated from both central areas with maximum on the left side. Oxcarbazepine was effective in controlling this reflex epileptic seizure.
키워드
Reflex epilepsy;Writing epilepsy
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