Ictal video-polygraphic features of perioral myoclonia with absences

Giuseppe d'Orsi, Vincenzo Demaio, Marina Trivisano, Maria Grazia Pascarella, Luigi M. Specchio

Research output: Contribution to journalArticlepeer-review

Abstract

There have been few case reports of perioral myoclonia with absences (POMA) because of the lack of video-polygraphic recordings clarifying the electroencephalogram (EEG)-electromyogram (EMG) correlations. We describe one of the first video-polygraphic studies of POMA in a patient who underwent repeated and prolonged split-screen video-polygraphic recordings. The ictal EEG showed generalized and irregular discharges of spikes or multiple spikes and slow waves, while two concomitant EMG patterns appeared: (1) a rhythmic enhancement of the orbicularis oris and masseter muscles on both sides with minimal asymmetry corresponding to perioral movements, and (2) a progressive increment in muscular tone in the mylohyoideus muscle corresponding to oroalimentary automatisms. Myoclonic jerks were inconstantly time-locked to the spike component of the spike-wave complex. The evidence of a complex pattern of activation of the facial muscles suggests that the involvement of subcortical central pattern generators, related to masticatory activity, through the disinhibitory effect of the spike-wave discharge is a possible pathophysiological mechanism underlying POMA.

Original languageEnglish
Pages (from-to)314-317
Number of pages4
JournalEpilepsy and Behavior
Volume21
Issue number3
DOIs
Publication statusPublished - Jul 2011

Keywords

  • Classification
  • Electromyography
  • Idiopathic generalized epilepsy
  • Perioral myoclonia with absences
  • Video-polygraphy

ASJC Scopus subject areas

  • Clinical Neurology
  • Behavioral Neuroscience
  • Neurology

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