Reorganization of Motor Representation in a Patient with Epilepsia Partialis Continua as Shown by [O15]‐Labeled Butanol Positron Emission Tomography and Functional Magnetic Resonance Imaging

The authors investigated a 38‐year‐old patient with focal cortical dysplasia in the right precentral cortex using positron emission tomography and functional magnetic resonance imaging to localize the hand and finger motor representations. The patient presented clinically with epilepsia partialis continua, supposed to originate from the perirolandic area harboring the cortical malformation. Both methods revealed an abnormal bilateral activation of motor cortex during left‐hand finger movements. The results suggest that the so‐called eloquent but nevertheless pathological dysplastic cortex accommodates motor representations.

[1]  M R Symms,et al.  EEG-triggered functional MRI of interictal epileptiform activity in patients with partial seizures. , 1999, Brain : a journal of neurology.

[2]  K Herholz,et al.  Three-dimensional alignment of functional and morphological tomograms. , 1990, Journal of computer assisted tomography.

[3]  S. Spencer.  The Relative Contributions of MRI, SPECT, and PET Imaging in Epilepsy , 1994, Epilepsia.

[4]  T. Rasmussen,et al.  INTRACAROTID INJECTION OF SODIUM AMYTAL FOR THE LATERALIZATION OF CEREBRAL SPEECH DOMINANCE EXPERIMENTAL AND CLINICAL OBSERVATIONS , 1960 .

[5]  P. Juul-Jensen,et al.  Epilepsia partialis continua. , 1966, Archives of neurology.

[6]  P. Grasby,et al.  Cerebral activation in malformations of cortical development. , 1998, Brain : a journal of neurology.

[7]  J R Ives,et al.  EEG-triggered echo-planar functional MRI in epilepsy , 1996, Neurology.

[8]  B R Rosen,et al.  Activation of distinct motor cortex regions during ipsilateral and contralateral finger movements. , 1999, Journal of neurophysiology.

[9]  J. B. Demb,et al.  Functional MRI measurement of language lateralization in Wada-tested patients. , 1995, Brain : a journal of neurology.

[10]  G. Schlaug,et al.  Differential magnetic resonance signal change in human sensorimotor cortex to finger movements of different rate of the dominant and subdominant hand. , 1998, Brain research. Cognitive brain research.

[11]  G. Schlaug,et al.  Cerebral activation covaries with movement rate , 1996, Neuroreport.

[12]  G. Hagemann,et al.  Uncoupling of Blood Flow and Metabolism in Focal Epilepsy , 1998, Epilepsia.

[13]  D. Klass,et al.  Epilepsia partialis continua. A review of 32 cases. , 1977, Archives of neurology.

[14]  A. P. Georgopoulos,et al.  Functional magnetic resonance imaging of motor cortex: hemispheric asymmetry and handedness. , 1993, Science.

[15]  Y. Burnod,et al.  Functional MRI in double cortex: Functionality of heterotopia , 2000, Neurology.

[16]  R. Seitz,et al.  Cerebral reorganization in man after acquired lesions. , 1999, Advances in neurology.

[17]  H. Herzog,et al.  Quantitation of Regional Cerebral Blood Flow with 15O-Butanol and Positron Emission Tomography in Humans , 1996, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[18]  U Pietrzyk,et al.  An interactive technique for three-dimensional image registration: validation for PET, SPECT, MRI and CT brain studies. , 1994, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[19]  E KUGELBERG,et al.  Epilepsia partialis continua. , 1954, Electroencephalography and clinical neurophysiology.

[20]  A. Alavi,et al.  Complex partial epilepsy: the role of neuroimaging in localizing a seizure focus for surgical intervention. , 1990, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[21]  H. Alkadhi,et al.  Localization of the motor hand area to a knob on the precentral gyrus. A new landmark. , 1997, Brain : a journal of neurology.