A case of frontal lobe seizures with ‘dancing‐like’ semiology

• Published in: European journal of neurology Vol. 31; no. 9; pp. e16348 - n/a
• Main Authors: Atanasio, Giorgia, Germanò, Antonio, Granata, Francesca, Tomaiuolo, Francesco, Labate, Angelo
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.09.2024; John Wiley and Sons Inc
• Subjects: Blood flow; Case Report; Case reports; Cerebral blood flow; complex motor behaviour; Convulsions & seizures; dancing semiology; dancing‐like seizures; Drug Resistant Epilepsy - physiopathology; EEG; Electroencephalography; Epilepsy; Epilepsy, Frontal Lobe - diagnosis; Epilepsy, Frontal Lobe - diagnostic imaging; Epilepsy, Frontal Lobe - physiopathology; Female; Frontal lobe; Frontal Lobe - diagnostic imaging; Frontal Lobe - physiopathology; frontal lobe seizures; frontal polymicrogyria; Humans; Magnetic Resonance Imaging; Middle Aged; Pelvis; Polymicrogyria; Seizures; Seizures - diagnostic imaging; Seizures - etiology; Seizures - physiopathology; Semiotics; Stimulators; Vagus nerve; Vagus Nerve Stimulation; Video; dancing‐like seizures; frontal polymicrogyria; dancing semiology; complex motor behaviour; frontal lobe seizures
• ISSN: 1351-5101; 1468-1331; 1468-1331
• DOI: 10.1111/ene.16348

Background and purpose ‘Dancing‐like’ semiology is extremely rare and described in few case reports. It is characterized by rhythmic, oscillatory movements of the pelvis and/or limbs during which the subject appears to be dancing. It has been associated with both the frontal and temporal epileptic zone; however, the possible network involved in these fascinating seizures is unclear. Methods The case of a 45‐year‐old woman suffering from drug‐resistant focal epilepsy with multi‐day seizures of bizarre semiology is described. A structural and perfusion magnetic resonance imaging study (interictal and peri‐ictal) and video‐electroencephalograms were carried out, and several home videos were employed. A vagal stimulator was implanted. Results Home videos documented the ‘dancing’ semiology of seizures better than video‐ electroencephalogram recordings. The imaging study revealed a focal frontal polymicrogyria with a peri‐ictal cerebral blood flow increase at the perisylvian lesion foci. The combination of add‐on cenobamate and vagal nerve stimulation resulted in complete seizure freedom. Conclusion The unusual and complex dancing‐like semiology observed during our patient's seizures adds to the repertoire of fascinating complex motor manifestations of frontal lobe epilepsy.