Refractory musicogenic epilepsy and a surgical cure guided by metabolic neuroimaging: A case report

Abstract

A 40-year-old female patient with refractory musicogenic epilepsy and non-lesional magnetic resonance imaging neuroimaging is highlighted in this report. A right temporal lobectomy was necessary and sufficient to effect a durable surgical cure without recurrence for over approximately 18 years in follow-up while remaining off seizure medications for the prior 16 years. Our case report delineates that this patient was cured with a surgical resection guided by metabolic neuroimaging. This patient was evaluated for cerebral localization of seizure onsets to guide further therapy in an epilepsy center and the evaluation for localization of seizure onset identified that Ictal single photon emission computed tomography (SPECT) imaging identified an approximately 25% increase in blood flow or metabolism in the right temporal lobe during seizures compared with the baseline. Seizure semiology and electroencephalography localization were concordant with SPECT localization.

Keywords

Intractable epilepsy / Metabolic neuroimaging / Non-lesional epilepsy / Surgery

Funding

None.

Conflict of interest

The authors have no conflict of interests to declare.

References

[1] Palmini A, Halasz P, Scheffer IE, et al. Reflex seizures in patients with malformations of cortical development and refractory epilepsy. Epilepsia. 2005; 46(8):1224-1234. doi: 10.1111/j.1528-1167.2005.52904.x

[2] Grosso S, Farnetani MA, Francione S, et al. Hot water epilepsy and focal malformation of the parietal cortex development. Brain Dev. 2004; 26(7):490-493. doi: 10.1016/j.braindev.2003.12.004

[3] Gelisse P, Thomas P, Padovani R, Hassan-Sebbag N, Pasquier J, Genton P. Ictal SPECT in a case of pure musicogenic epilepsy. Epileptic Disord. 2003; 5(3):133-137.

[4] Pinto D, Westland B, de Haan GJ, et al. Genome-wide linkage scan of epilepsy-related photoparoxysmal electroencephalographic response: Evidence for linkage on chromosomes 7q32 and 16p13. Hum Mol Genet. 2005; 14(1):171-178. doi: 10.1093/hmg/ddi018

[5] Pinto D, Kasteleijn-Nolst Trenité DG, Cordell HJ, et al. Explorative two-locus linkage analysis suggests a multiplicative interaction between the 7q32 and 16p13 myoclonic seizures-related photosensitivity loci. Genet Epidemiol. 2007; 31(1):42-50. doi: 10.1002/gepi.20190

[6] Prasad DK, Satyanarayana U, Munshi A. Genetics of idiopathic generalized epilepsy: An overview. Neurol India. 2013; 61(6):572-577. doi: 10.4103/0028-3886.125240

[7] Cho JW, Seo DW, Joo EY, Tae WS, Lee J, Hong SB. Neural correlates of musicogenic epilepsy: SISCOM and FDG-PET. Epilepsy Res. 2007; 77(2-3):169-173. doi: 10.1016/j.eplepsyres.2007.09.013

[8] Goffin K, Dedeurwaerdere S, Van Laere K, Van Paesschen W. Neuronuclear assessment of patients with epilepsy. Semin Nucl Med. 2008; 38(4):227-239. doi: 10.1053/j.semnuclmed.2008.02.004

[9] La Fougère C, Rominger A, Förster S, Geisler J, Bartenstein P. PET and SPECT in epilepsy: A critical review. Epilepsy Behav. 2009; 15(1):50-55. doi: 10.1016/j.yebeh.2009.02.025

[10] Bratu IF, Nica AE, Oane I, et al. Musicogenic seizures in temporal lobe epilepsy: Case reports based on ictal source localization analysis. Front Neurol. 2023;14:1072075. doi: 10.3389/fneur.2023.1072075

[11] Stern J. Musicogenic epilepsy. Handb Clin Neurol. 2015;129:469-477. doi: 10.1016/B978-0-444-62630-1.00026-3

[12] Kaplan PW. Musicogenic epilepsy and epileptic music: A seizure’s song. Epilepsy Behav. 2003; 4(5):464-473. doi: 10.1016/s1525-5050(03)00172-0

[13] Stern JM, Tripathi M, Akhtari M, Korb A, Engel J, Cohen MS. Musicogenic seizure localization with simultaneous EEG and functional MRI (SEM). Neurology. 2006; 66(Suppl.2):90.

[14] Tayah TF, Abou-Khalil B, Gilliam FG, Knowlton RC, Wushensky CA, Gallagher MJ. Musicogenic seizures can arise from multiple temporal lobe foci: Intracranial EEG analyses of three patients. Epilepsia. 2006; 47(8):1402-1406. doi: 10.1111/j.1528-1167.2006.00609.x

[15] Duanyu N, Yongjie L, Guojun Z, Lixin C, Liang Q. Surgical treatment for musicogenic epilepsy. J Clin Neurosci. 2010; 17(1):127-129. doi: 10.1016/j.jocn.2009.01.022

[16] Goldman RI, Stern JM, Engel J Jr., Cohen MS. Acquiring simultaneous EEG and functional MRI. Clin Neurophysiol. 2000; 111(11):1974-1980. doi: 10.1016/S1388-2457(00)00456-9

[17] Brien SE, Murray TJ. Musicogenic epilepsy. Can Med Assoc J. 1984; 131(10):1255-1258.