뇌염후 전화 통화로 유발되는 음악 유발성 간질의 1례

Abstract

Background: Seizure evoked by a variety of simple and complex sensory stimuli are called reflex epilepsy. Among the various sensory stimuli, musicogenic epilepsy is provoked exclusively by listening to music. Musicogenic epilepsy is typically of a complex partial type, with or without secondary generalization. EEG abnormalities are usually recorded from the temporal lobe and show a right-side preponderance.

Case: A 34-year-old male patient was admitted due to mental change. He was treated under the diagnosis of encephalitis and improved after several days. But complex partial and generalized tonic-clonic seizure was developed. His seizure was occurred spontaneously, but more often provoked when talking about by telephone. Brain MRI revealed no gross abnormality. Ictal brain SPECT (HMPAO) showed hyperperfusion in the right temporal region. EEG showed focal slowing in the right temporal region and no provocation by click sound through the BAEP and photic stimuli.

Conclusion: This case is musicogenic epilepsy provoked by conversation through the telephone. Presumably, the primary auditory area of the temporal lobe was activated by encephalitis and these hyperexcitable cortical areas stimulated by only distorted voice through the telephone, but not by usual conversation, induce seizure.