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Tracking the source of cerebellar epilepsy: hemifacial seizures associated with cerebellar cortical dysplasia

Lemkaddem, Alia
Schmitt-Mechelke, Thomas
Thiran, Jean-Philippe
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Published in Epilepsy Research. 2013, vol. 105, no. 1-2, p. 245-9
Abstract Traditionally, subcortical structures such as the cerebellum are supposed to exert a modulatory effect on epileptic seizures, rather than being the primary seizure generator. We report a 14-month old girl presenting, since birth, with seizures symptomatic of a right cerebellar dysplasia, manifested as paroxystic contralateral hemifacial spasm and ipsilateral facial weakness. Multimodal imaging was used to investigate both anatomical landmarks related to the cerebellar lesion and mechanisms underlying seizure generation. Electric source imaging (ESI) supported the hypothesis of a right cerebellar epileptogenic generator in concordance with nuclear imaging findings; subsequently validated by intra-operative intralesional recordings. Diffusion spectrum imaging-related tractography (DSI) showed severe cerebellar structural abnormalities confirmed by histological examination. We suggest that hemispheric cerebellar lesions in cases like this are likely to cause epilepsy via an effect on the facial nuclei through ipsilateral and contralateral aberrant connections.
Keywords AdolescentCerebellar Cortex/abnormalities/pathologyCerebellar Diseases/complications/diagnosisEpilepsy/diagnosis/etiologyFemaleHemifacial Spasm/diagnosis/etiologyHumans
PMID: 23375885
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Research groups Epilepsie et Chirurgie (149)
Groupe Menache Starobinski Caroline (881)
Laboratoire de neuroimagerie et de traceurs moléculaires innovants (984)
Epilepsie et réseaux cérébraux (1002)
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LASCANO, Agustina Maria et al. Tracking the source of cerebellar epilepsy: hemifacial seizures associated with cerebellar cortical dysplasia. In: Epilepsy Research, 2013, vol. 105, n° 1-2, p. 245-9. doi: 10.1016/j.eplepsyres.2012.12.010 https://archive-ouverte.unige.ch/unige:35264

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Deposited on : 2014-04-02

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