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Tracking the source of cerebellar epilepsy: hemifacial seizures associated with cerebellar cortical dysplasia.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Publication date 2013
Author Lascano Agustina M, Lemkaddem Alia, Granziera Cristina, Korff Christian M, Boex Colette, Jenny Benoit, Schmitt-Mechelke Thomas, Thiran Jean-Philippe, Garibotto Valentina, Vargas Maria Isabel, Schaller Karl, Seeck Margitta, Vulliemoz Serge,
Project Fast Global Tractography for Sensitive MR Connectomics
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Original article (peer-reviewed)

Journal Epilepsy research
Volume (Issue) 105(1-2)
Page(s) 245 - 9
Title of proceedings Epilepsy research
DOI 10.1016/j.eplepsyres.2012.12.010

Abstract

Traditionally, subcortical structures such as the cerebellum are supposed to exert a modulatory effect on epileptic seizures, rather than being the primary seizure generator. We report a 14-month old girl presenting, since birth, with seizures symptomatic of a right cerebellar dysplasia, manifested as paroxystic contralateral hemifacial spasm and ipsilateral facial weakness. Multimodal imaging was used to investigate both anatomical landmarks related to the cerebellar lesion and mechanisms underlying seizure generation. Electric source imaging (ESI) supported the hypothesis of a right cerebellar epileptogenic generator in concordance with nuclear imaging findings; subsequently validated by intra-operative intralesional recordings. Diffusion spectrum imaging-related tractography (DSI) showed severe cerebellar structural abnormalities confirmed by histological examination. We suggest that hemispheric cerebellar lesions in cases like this are likely to cause epilepsy via an effect on the facial nuclei through ipsilateral and contralateral aberrant connections.
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