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DOI: 10.1055/s-2000-9237
Georg Thieme Verlag Stuttgart · New York
Intermittent Falls and Fecal Incontinence as a Manifestation of Epileptic Negative Myoclonus in Idiopathic Partial Epilepsy of Childhood
Publication History
Publication Date:
31 December 2000 (online)
We report two children, suffering from idiopathic partial epilepsy, who started to present, in the same period of time, with epileptic negative myoclonus (ENM) in one lower limb and fecal incontinence (FI). Polygraphic recordings showed that ENM was associated with paroxysmal activities distributed over the vertex region. Both ENM and FI disappeared when ethosuximide treatment was started. We hypothesize that, in our patients, ENM in one lower limb and FI depended on a transitory impairment, caused by epileptic activity that altered the functionality of nearby cortical areas, located in fronto-mesial regions, involved in the control of the muscular tone of the lower limbs and of the pelvic floor muscles.
Key words
Epileptic negative myoclonus - Fecal incontinence - Ethosuximide - Childhood partial epilepsy - Somatotopy
References
- 1 Andrew J, Nathan W. Lesions of the anterior frontal lobes and disturbances of micturition and defaecation. Brain. 1964; 233-262
- 2 Baumgartner C, Podreka I, Olbrich A, Novak K, Serles W, Aull S. et al . Epileptic negative myoclonus: an EEG-single-photon emission CT study indicating involvement of premotor cortex. Neurology. 1996; 46 753-758
- 3 Capovilla G, Beccaria F, Veggiotti P, Rubboli G, Meletti S, Tassinari C A. Ethosuximide is effective in the treatment of epileptic negative myoclonus in childhood partial epilepsy. J Child Neurol. 1999; 14 (6) 395-400
- 4 Guerrini R, Dravet C, Genton P, Bureau M, Roger J, Rubboli G. et al . Epileptic negative myoclonus. Neurology. 1993; 43 1078-1083
- 5 Lance J. Negative myoclonus. Correspondence. Neurology. 1994; 44 (5) 989
- 6 Noachtar S, Holthausen H, Luders H O. Epileptic negative myoclonus. Subdural EEG recordings indicate a postcentral generator. Neurology. 1997; 49 1534-1537
- 7 Oguni H, Uehara T, Tanaka T, Sunahara M, Hara M, Osawa M. Dramatic effect of ethosuximide on epileptic negative myoclonus: implications for the neurophysiological mechanism. Neuropediatrics. 1998; 29 29-34
- 8 Penfield W, Rasmussen T. The Cerebral Cortex of Man. A Clinical Study of Localization of Function. New York; Macmillan 1950
- 9 Rubboli G, Parmeggiani L, Tassinari C A. Frontal inhibitory spike component associated with epileptic negative myoclonus. Electroencephalogr Clin Neurophysiol. 1995; 95 201-205
- 10 Rubboli G, Tassinari C A. Epileptic negative myoclonus. Subdural EEG recordings indicate a postcentral generator. Correspondence. Neurology. 1998; 51 (5) 1518-1519
- 11 Sherrington C S. The Integrative Action of the Nervous System. Cambridge; University Press 1947
- 12 Shirasaka Y, Mitsuyoshi I. A case of epileptic negative myoclonus: therapeutic considerations. Brain Dev. 1999; 21 (3) 209-212
- 13 Tassinari C A, Regis H, Gastaut H. A particular form of muscular inhibition in epilepsy: the related epileptic silent period (RESP). Proc Aust Assoc Neurol. 1968; 5 595-602
-
14 Tassinari C A.
New perspectives in epileptology. Trends in Modern Epileptology. Proc Int Publ Semin on Epileptology. Tokyo; Japanese Epilepsy Association 1981: 42-59 -
15 Tassinari C A, Rubboli G, Parmeggiani L, Valzania F, Plasmati R, Riguzzi P. et al .
Epileptic negative myoclonus. Fahn S, Hallett M, Luders HO, Marsden CD Negative Motor Phenomena. Advances in Neurology. Vol. 67. Philadelphia; Lippincott-Raven 1995: 181-197 - 16 Tassinari C A, Rubboli G, Gardella E. Negative myoclonus. Clin Neuroscience. 1996; 3 209-213
- 17 Ugawa Y. Negative myoclonus. Correspondence. Neurology. 1994; 44 (5) 989
Giuseppe Capovilla
Department of Child Neuropsychiatry
C. Poma Hospital
Viale Albertoni 1
96100 Mantova
Italy