Neural correlates of musicogenic epilepsy: SISCOM and FDG-PET

To localize the neural correlates of musicogenic epilepsy, subtraction ictal SPECT coregistered with MRI (SISCOM) and 18F-fluorodeoxy glucose positron emission tomography (FDG-PET) were performed in a woman who had suffered from frequent musicogenic seizures. She had complex partial seizures consisting of palpitation and an unpleasant feeling, which were followed by staring and oroalimentary automatisms. Ictal EEG showed rhythmic theta waves originated from the right temporal lobe, and SISCOM showed ictal hyperperfusion on right insula, amygdala, hippocampal head, and anterior temporal lobe, whereas interictal FDG-PET showed interictal hypometabolism in the same brain regions, suggesting dysfunction and abnormal activation of right temporo-limbic structures related to an emotional response to music.