This report documents the clinical features of supplementary motor area seizures with voluntary movements in two patients. The first case describes a 13-year-old boy with a 2-year history of nocturnal seizures, characterized by an asymmetrical brief tonic posture followed by bilateral rapid hand shaking, but without impaired awareness. Magnetic resonance imaging revealed no abnormalities. Video electroencephalogram indicated interictal focal spikes and ictal activity 2 s before clinical onset in the frontal midline area. The patient stated that he purposely shook his hands to lessen the seizure-induced upper limb stiffness. The second case describes a 43-year-old man with a 33-year history of nocturnal seizures, characterized by an asymmetric brief tonic posture, with the right hand grabbing to hold this posture, but without impaired awareness. Video electroencephalogram indicated that he voluntarily moved his right hand during the latter part of the seizures; however, no clear ictal electroencephalogram change was noted. Magnetic resonance imaging revealed a mass lesion in the right medial superior frontal gyrus. Fluorodeoxyglucose-positron emission tomography and ictal single-photon emission computed tomography indicated ictal focus in the mesial frontal area, as confirmed by invasive electroencephalogram and seizure freedom after surgery. Both patients had typical supplementary motor area seizures, except they could perform voluntary movements in the body parts. The co-occurrence of supplementary motor area seizures and voluntary movements is clinically useful, as it may help avoid the inaccurate and misleading diagnosis of non-epileptic events such as psychogenic non-epileptic seizures.
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http://dx.doi.org/10.1002/epd2.20047 | DOI Listing |
Neurophysiol Clin
December 2024
Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, The Cranial Nerve Disease Center of Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai 200092, China. Electronic address:
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Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; and.
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Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand.
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Department of Psychology, Graduate School of Humanities, Chiba University, Chiba, Japan.
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View Article and Find Full Text PDFJ Prev Interv Community
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Leaders undertaking the effort to dismantle structural inqualities at the organizational level often find traditional professional development on diversity, equity, and inclusion to be limited in scope, rarely leading to meaningful organizational change. The Racial Equity, Diversity, and Inclusion (REDI) Movement was developed in 2020 by associates within a Midwest university research center to increase efforts toward the pursuit of a holistic, systems-level approach to equity, social justice, and inclusion. REDI now includes several interventions that prepare associates and their teams to advance racial justice and equity across four levels of the REDI Framework: Intrapersonal, Interpersonal, Institutional, and Societal.
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