Alteration of the cortical motor map in a patient with intractable focal seizures

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Abstract

Patients with epilepsia partialis continua may develop progressive neurological deficits of unclear origin. It is possible that repetitive epileptic spikes induce plastic changes in the cortex analogous to the changes observed following direct microstimulation. A child is reported with focal cortical dysplasia, intractable focal seizures, worsening hemiparesis, and alteration of the cortical motor map over time. At age 7, he underwent cortical motor mapping before partial resection of a seizure focus within the right postcentral gyrus. No deficits were present after surgery, and seizure frequency declined by more than 90%. Seizures subsequently worsened and a progressive left hemiparesis developed. Cortical remapping at age 12 showed motor centres for left arm, face, and eye movements in an unusual configuration. The location of the motor representation of the face differed from the location obtained at age 7. This case provides direct electrophysiological evidence of reorganisation of the cortical motor map in the human brain.

Original languageEnglish (US)
Pages (from-to)812-815
Number of pages4
JournalJournal of Neurology Neurosurgery and Psychiatry
Volume72
Issue number6
DOIs
StatePublished - Jun 5 2002

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ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

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