Movement disorders phenomenology in focal motor seizures

Alfonso Fasano; Carlo Di Bonaventura; Francesco Bove; Alberto J Espay; Francesca Morgante; Giovanni Fabbrini; Renato P Munhoz; Danielle Andrade; Felipe Borlot; Esther Bui; Giancarlo Di Gennaro; Raffaele Iorio; Hans Katzberg; Marco Luigetti; Pasquale Striano; Giovanni Defazio; Alfredo Berardelli

doi:10.1016/j.parkreldis.2018.10.021

Movement disorders phenomenology in focal motor seizures

Parkinsonism Relat Disord. 2019 Apr:61:161-165. doi: 10.1016/j.parkreldis.2018.10.021. Epub 2018 Oct 16.

Authors

Alfonso Fasano¹, Carlo Di Bonaventura², Francesco Bove³, Alberto J Espay⁴, Francesca Morgante⁵, Giovanni Fabbrini⁶, Renato P Munhoz⁷, Danielle Andrade⁸, Felipe Borlot⁹, Esther Bui¹⁰, Giancarlo Di Gennaro¹¹, Raffaele Iorio³, Hans Katzberg¹², Marco Luigetti³, Pasquale Striano¹³, Giovanni Defazio¹⁴, Alfredo Berardelli⁶

Affiliations

¹ Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada; Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Krembil Brain Institute, Toronto, Ontario, Canada. Electronic address: alfonso.fasano@gmail.com.
² Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
³ Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurologia, Rome, Italy; Institute of Neurology, Università Cattolica del Sacro Cuore, Italy.
⁴ Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA.
⁵ Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.
⁶ Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; IRCSS Neuromed, Pozzilli, IS, Italy.
⁷ Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada; Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Krembil Brain Institute, Toronto, Ontario, Canada.
⁸ Krembil Brain Institute, Toronto, Ontario, Canada; Toronto Western Hospital and Division of Neurology, University of Toronto, Toronto, Ontario, Canada.
⁹ Division of Neurology, Hospital for Sick Children (SickKids), University of Toronto, Toronto, Ontario, Canada.
¹⁰ Toronto Western Hospital and Division of Neurology, University of Toronto, Toronto, Ontario, Canada.
¹¹ IRCSS Neuromed, Pozzilli, IS, Italy.
¹² Prosserman Centre for Neuromuscular Diseases, Toronto General Hospital and Division of Neurology, University of Toronto, Toronto, Ontario, Canada.
¹³ Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, "G. Gaslini" Institute, Genova, Italy.
¹⁴ Department of Medical Science and Public Health, Neurology Unit, University of Cagliari, Italy.

PMID: 30361137
DOI: 10.1016/j.parkreldis.2018.10.021

Abstract

Introduction: Although focal motor seizures may resemble one or more movement disorders their phenomenology and prevalence remain uncertain.

Methods: To examine the extent to which focal motor seizures can present with a phenomenology fulfilling diagnostic criteria for movement disorders, 100 consecutive patients with focal motor seizures were rated by movement disorders experts, epileptologists, and general neurologists.

Results: A focal motor seizure phenomenologically manifested as a defined movement disorder in 29% of the patients from a consecutive video-EEG documented cohort as per consensus among experts: myoclonus and dystonia (10 and 9 cases, respectively) were the most common movement disorders, followed by chorea (4), stereotypies (3) myoclonus-dystonia (2), and tremor (1).

Conclusions: Movement disorders and focal motor epilepsy share overlapping movement phenomenology.

Keywords: Dystonia; Epilepsy; Focal seizure; Movement disorders; Myoclonus.

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Chorea / etiology
Chorea / physiopathology*
Cohort Studies
Dystonia / etiology
Dystonia / physiopathology*
Electroencephalography
Epilepsy, Partial, Motor / complications
Epilepsy, Partial, Motor / physiopathology*
Female
Humans
Male
Middle Aged
Movement Disorders / etiology
Movement Disorders / physiopathology*
Myoclonus / etiology
Myoclonus / physiopathology*
Stereotypic Movement Disorder / etiology
Stereotypic Movement Disorder / physiopathology*
Tremor / etiology
Tremor / physiopathology*
Young Adult