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October 1984

Epilepsia Partialis Continua: Epileptogenic Focus in Motor Cortex and Its Participation in Transcortical Reflexes

Author Affiliations

From the Department of Neurology, Institute of Brain Research, Faculty of Medicine, University of Tokyo. Dr Kuroiwa is now with the Department of Neurology, Iwate University School of Medicine, Morioka, Japan.

Arch Neurol. 1984;41(10):1040-1044. doi:10.1001/archneur.1984.04050210038011

• We performed electrophysiologic and neuroradiologic studies on a patient who had epilepsia partialis continua (EPC) to elucidate the pathophysiologic mechanism of repeated myoclonic jerks confined to the right toes. A computed tomographic scan revealed a small cortical lesion in the left parasagittal rolandic area corresponding to the sensorimotor cortex of the right toes. A pretrigger EEG analysis with a jerk-locked averaging technique revealed a positive spike 32 ms before the jerks. A similar positive spike was evoked at a latency of 48 ms after an electrical stimulation of the right posterior tibial nerve; it was followed by a myoclonic jerk with a 32-ms latency. We suppose that in our patient, an epileptogenic focus in the motor cortex and transcortical long-loop reflexes played an important role in generating EPC.

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