Rotational vestibular epilepsy from the temporo-parieto-occipital junction

Abstract

Humans likely have multiple cortical areas for processing vestibular information rather than a primary vestibular cortex.1 The parietal, temporal, and frontal lobes contain areas that receive vestibular input, with the temporo-perisylvian vestibular cortex having a dominant role.2 Cortical stimulation studies and naturally occurring lesions such as strokes have helped map the human vestibular cortex. Alternatively, partial seizures can serve as a natural form of cortical stimulation for mapping human cortical function. Ictal EEG recordings demonstrate that the posterior portion of the middle frontal gyrus receives rotational vestibular input and can serve as the focus for epileptic rotational vertigo.3 Although previous studies implicate the parieto-temporal area as a focus for vestibular epilepsy,4 direct clinical evidence is lacking. We report a boy with partial epilepsy characterized by rotational vertigo and ipsilateral head and eye deviation with jerking eye movements triggered visually following a moving object. An otherwise healthy, developmentally normal 8-year-old boy was evaluated for a 3-year history of episodes of dizziness and eye jerking. These episodes lasted <1 …