ACTIVATION OF THE FRONTO-PARIETAL OPERCULUM IN THE CORTICAL FOCAL NEGATIVE MYOCLONUS
Abstract number :
2.403
Submission category :
Year :
2003
Submission ID :
3842
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Patrick Van Bogaert, Christophe Phillips, Xavier De Tiege, Denis Verheulpen, Pierre Maquet, Serge Goldman Pediatric Neurology, ULB-Hopital Erasme, Brussels, Belgium; Cyclotron Research Center, University of Liege, Liege, Belgium; PET/Biomedical Cyclotron
The origin of the cortical focal negative myoclonus has not been fully determined yet. We investigated whether the study of regional cerebral metabolism for glucose combined with EEG source localization could help to its localization.
Two patients aged 8 and 10 years with negative myoclonus of the left upper limb diagnosed by simultaneous video EEG-EMG recording were studied by positron emission tomography (PET) with 18F-fluorodeoxyglucose. The first patient had a progressive myoclonic epilepsy of undetermined etiology. The second one had an idiopathic partial epilepsy and negative myoclonus resolved after withdrawal of phenytoin. In both cases, the focal negative myoclonus was associated with a negative spike over the right central region. PET data were analyzed using a voxel-based method, statistical parametric mapping 99. The scans of each patient were compared with those of a control group of young adults using a height threshold at P=0.001. The regions of significant abnormal metabolism were localized in the Talairach anatomical space. Equivallent current dipoles estimated from the EEG ictal spikes were localized in the same anatomical space.
In both cases, a highly significant hypermetabolic area (P[lt]0.05 after correction for multiple comparisons) was found in the opercular portions of the precentral and post-central gyri contralateral to the myoclonus. The figure illustrates PET data of patient 2. Equivallent current dipoles were found in close anatomical relationship with the areas of increased glucose metabolism.
The cortical focal negative myoclonus is associated with activation of the frontal and parietal opercular regions.[figure1]
