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Epilepsia partialis continua with dystonic hand movement in a patient with a malformation of cortical development

Authors

  • Julie Zyss MD,

    1. Université de Lyon, Hospices Civils de Lyon, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Service de Neurologie C, Lyon, France
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  • Jing Xie-Brustolin MD, PhD,

    1. Université de Lyon, Hospices Civils de Lyon, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Service de Neurologie C, Lyon, France
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  • Philippe Ryvlin MD, PhD,

    1. Université de Lyon, Hospices Civils de Lyon, CTRS-IDEE, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Service de Neurologie Fonctionnelle et d'Epileptologie, Lyon, France
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  • Stéphane Peysson MD,

    1. Université de Lyon, Hospices Civils de Lyon, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Service de Neurologie C, Lyon, France
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  • Albert Beschet MD,

    1. Centre Hospitalier Valence, Service de Neurologie, Valence, France
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  • Dominique Sappey-Marinier MD, PhD,

    1. Université de Lyon, CERMEP-Imagerie du vivant, 69677 Bron, France
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  • Marc Hermier MD, PhD,

    1. Hospices Civils de Lyon, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Service de Neuroradiologie, Lyon, France
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  • Stéphane Thobois MD, PhD

    Corresponding author
    1. Université de Lyon, Hospices Civils de Lyon, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Service de Neurologie C, Lyon, France
    2. INSERM U 864, Bron, France
    • Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C,59 Bd Pinel, 69003 Lyon, France
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Abstract

Malformations of cortical development (MCD) with polymicrogyria and schizencephaly are due to abnormal cortical organization and usually manifest by intractable epilepsy and mental retardation. Epileptical activity is often hard to register and focal dystonia associated with such MCD has previously been described but without any metabolic imaging. We report here a 46-year-old man presenting with late-onset atypical abnormal movements of his left hand associated with right central region MCD. To demonstrate the involvement of an epileptical focus, we performed [18F]FDG-PET and fMRI both before and after a single dose of clobazam and diazepam, respectively. Characteristics of the abnormal hand movements, clinical response to the medication, and the result of the [18F]FDG-PET and fMRI investigations all favor the diagnosis of epilepsia partialis continua. We conclude that the dystonic movement is part of the partial seizure. © 2007 Movement Disorder Society

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