Musicogenic reflex seizures in epilepsy with glutamic acid decarbocylase antibodies

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Excerpt

The term musicogenic epilepsy was first coined by Critchley,1 who described a rare form of epilepsy in which seizures, typically simple or complex partial types, were triggered by music. However, descriptions of possible music‐induced seizures had been reported in the literature as early as 1841.
Musicogenic epilepsy has an estimated prevalence of one case per 10 000 000 population. It is classified as a rare form of complex reflex epilepsy by the International League Against Epilepsy (ILAE). Seizures were induced by listening to music in most cases, but playing, thinking, or dreaming of music have all been cited. Seizures following a musical stimulus can often be delayed by several minutes.
In a review which reported on 110 cases of music‐evoked seizures published between 1884 and 2007, the mean age of onset of musicogenic reflex seizures (MRS) was 28 years, with a female predominance.2 Patients more often than not had high musicality. Seizures induced exclusively by music occurred in 34 patients, with the majority also reporting spontaneous seizures. Autonomic auras were common with oromandibular automatisms occurring in more than one‐fourth of cases. In 60 patients with ictal electroencephalography (EEG), the focus of activity localized to the temporal lobe with right‐sided predominance. Ictal single photon emission computed tomography (SPECT) in six cases demonstrated abnormalities within the right temporal lobe involving mesial structures in four and within the left temporal lobe in two cases.
MRS have usually been reported in patients with normal structural magnetic resonance Imaging (MRI); 2 however, they have also been seen in patient with cortical dysplasia within the superior temporal gyrus,6 in patients with left frontotemporal astrocytoma,7 in patient with hippocampal sclerosis8 and in patient with Dravet syndrome.9 These seizures are probably not specific to any etiology, although in most cases, the etiology is not known.
The aim of this article was to retrospectively review the incidence of MRS in the general epileptic population controlled in our center and in the series of patients with epilepsy and GAD‐ab and to describe the clinical characteristics of patients with epilepsy and GAD‐ab whom suffered MRS.

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