Epileptic activity in mesial frontal cortex in nocturnal paroxysmal dystonia

Abstract

Nocturnal paroxysmal dystonia (NPD) describes dystonic-dyskinetic movements during sleep, and is a form of nocturnal frontal lobe epilepsy. We report the case of NPD arising from the mesial frontal lobe detected by subdural electrodes. A 25-year-old woman had daily NPD seizures. Her MRI showed no abnormalities. However, ictal single-photon emission computed tomography revealed hyperperfusion of the bilateral mesial frontal lobes. We implanted subdural electrodes and found ictal onset arising from the bilateral anterior mesial frontal cortices synchronously. Partial callosotomy reduced her symptoms without any neurological deficit.