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Kakisaka Y, Jehi L, Alkawadri R, Wang ZI, Enatsu R, Mosher JC, Dubarry AS, Alexopoulos AV, Burgess RC. Cephalic aura after frontal lobe resection. J Clin Neurosci 2014; 21:1450-2. [PMID: 24613491 DOI: 10.1016/j.jocn.2013.11.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Accepted: 11/10/2013] [Indexed: 10/25/2022]
Abstract
A cephalic aura is a common sensory aura typically seen in frontal lobe epilepsy. The generation mechanism of cephalic aura is not fully understood. It is hypothesized that to generate a cephalic aura extensive cortical areas need to be excited. We report a patient who started to have cephalic aura after right frontal lobe resection. Magnetoencephalography (MEG) showed interictal spike and ictal change during cephalic aura, both of which were distributed in the right frontal region, and the latter involved much more widespread areas than the former on MEG sensors. The peculiar seizure onset pattern may indicate that surgical modification of the epileptic network was related to the appearance of cephalic aura. We hypothesize that generation of cephalic aura may be associated with more extensive cortical involvement of epileptic activity than that of interictal activity, in at least a subset of cases.
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Affiliation(s)
- Yosuke Kakisaka
- Epilepsy Center, Department of Neurology, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA; Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan.
| | - Lara Jehi
- Epilepsy Center, Department of Neurology, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Rafeed Alkawadri
- The Department of Neurology, School of Medicine, Yale University, New Haven, CT, USA
| | - Zhong I Wang
- Epilepsy Center, Department of Neurology, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Rei Enatsu
- Epilepsy Center, Department of Neurology, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - John C Mosher
- Epilepsy Center, Department of Neurology, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Anne-Sophie Dubarry
- Epilepsy Center, Department of Neurology, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Andreas V Alexopoulos
- Epilepsy Center, Department of Neurology, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Richard C Burgess
- Epilepsy Center, Department of Neurology, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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