Abstract
A patient with intractable epilepsy, previous right frontal resection, and active vagus nerve stimulation (VNS) developed new onset quasi-continuous twitching around the left eye. Electroencephalography showed no correlate to the orbicularis oculi twitches apart from myographic potentials at the left supraorbital and anterior frontal electrodes. Magnetoencephalography was performed using spatiotemporal signal space separation to suppress magnetic artifacts associated with the VNS apparatus. Magnetoencephalographic source imaging performed on the data back-averaged from the left supraorbital myographic potentials revealed an intrasulcal cortical generator situated in the posterior wall of the right precentral gyrus representing the eye area of the motor homunculus.
Highlights
RÉSUMÉ: Localisation par magnétoencéphalographie de la zone oculaire qui correspond à l’homoncule moteur
A 35-year-old woman was referred to the epilepsy monitoring unit (EMU) because of intractable focal motor seizures and a 3month history of twitching of the left eye
Epilepsy was diagnosed at age 22 years; seizures commencing with left arm tingling and jerking of the arm, followed by left leg tingling and jerking, with or without secondary generalization
Summary
RÉSUMÉ: Localisation par magnétoencéphalographie de la zone oculaire qui correspond à l’homoncule moteur. Interpretation of the high-amplitude frontal spikes as myographic potentials associated with contractions of the left orbicularis oculi muscle (Figure 1A; corresponding video [MP4 format] available as Supplementary Material).
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