Eating seizures and emotional facial paresis: Evidence suggesting the amygdala is a common anatomophysiological substratum

Neurology Department, Hospital São João, Porto, Portugal.
Epilepsy & Behavior (Impact Factor: 2.26). 04/2005; 6(2):266-9. DOI: 10.1016/j.yebeh.2004.11.016
Source: PubMed


The medial basotemporal lobes (hippocampus, amygdala, parahippocampal gyrus) are considered to be parts of the system responsible for nonvolitional facial movements. In patients with temporal lobe epilepsy, lower facial weakness during emotional expression has been found to occur almost exclusively contralateral to the temporal lobe with the epileptogenic focus. Repetitive and chronic stimulation of the amygdala during eating has also been postulated as a probable mechanism for eating seizures. The authors present the illustrative aspects of both facial asymmetry and eating seizures in a case of mesial temporal lobe epilepsy (MTLE). This report provides evidence that the amygdala may be the common anatomical basis for three different aspects of this patient: emotional facial paresis, eating seizures, and sleep paroxysmal microarousals.

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    • "The attention–arousal coupling sustained by the meal is also claimed to play a role in triggering the attacks. Repetitive and chronic stimulation of amygdala during eating is proposed as the mechanism underlying eating epilepsy (Senanayake, 1994; Guimaraes et al., 2005). Established and new antiepileptic drugs are not effective in controlling the seizures (Loiseau et al., 1986). "
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    ABSTRACT: Food intake triggers convulsions in fasted mice and rats treated with antimuscarinic drugs, scopolamine or atropine. Bearing some similarities in triggering factor and manifestations of the seizures in patients with eating-evoked epilepsy, seizures in fasted animals may provide insight into the mechanism(s) of this rare and partially controlled form of reflex epilepsy.
    Preview · Article · Jul 2010 · Epilepsia
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    • "The most commonly reported somatomotor manifestations in TLE semiology occur in the face, neck, and upper extremities (Bossi et al., 1984). Orofacial movements involve both upper and lower facial musculature and include blinking, eye closure, bilateral facial contraction, contralateral hemifacial contraction, ipsilateral facial clonic jerks, perioral movements such as " lip smacking, " and a general change in overall facial expression (Bossi et al., 1984; Kotagal et al., 1995; Guimarães et al., 2005; Hogan and Rao, 2006). Suggestions have been made that these motor manifestations are a consequence of secondary generalization of a temporal epileptogenic focus, occurring through reciprocal cortico-cortical projections from mesial temporal structures to lateral temporal cortices, converging to the primary motor and premotor lateral cortices (Bossi et al., 1984). "
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    ABSTRACT: To assess the frequency and significance of facial paresis (FP) in a well-defined cohort of mesial temporal lobe epilepsy (MTLE) patients. One hundred consecutive patients with MRI findings consistent with mesial temporal sclerosis (MTS) and concordant electroclinical data underwent facial motor examination at rest, with voluntary expression, and with spontaneous smiling. Hippocampal, amygdaloid, and temporopolar (TP) volumetric measures were acquired. Thirty healthy subjects, matched according to age and sex, were taken as controls. Central-type FP was found in 46 patients. In 41 (89%) of 46, it was visualized at rest, with voluntary and emotional expression characterizing true facial motor paresis. In 33 (72%) of 46 patients, FP was contralateral to the side of MTS. By using a 2-SD cutoff from the mean of normal controls, we found reduction in TP volume ipsilateral to MTS in 61% of patients with FP and in 33% of those without (p = 0.01). Febrile seizures as initial precipitating injury (IPI) were observed in 34% of the patients and were classified as complex in 12 (26%) of 46 of those with FP and in five (9%) of 54 of those without (p = 0.02). The presence of FP was significantly associated with a shorter latent period and younger age at onset of habitual seizures, in particular, with secondarily generalized tonic-clonic seizures. Facial paresis is a reliable lateralizing sign in MTLE and was associated with history of complex febrile seizures as IPI, younger age at onset of disease, and atrophy of temporal pole ipsilateral to MTS, indicating more widespread disease.
    Full-text · Article · Sep 2007 · Epilepsia
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    ABSTRACT: We report a case of neonatal Eating Epilepsy. The baby was admitted to the Neonatal Intensive Care Unit of Chieti after delivery, with respiratory distress syndrome. In the first day of life the baby had an episode of arterial desaturation and cyanosis with EEG alterations. After laboratory and instrumental investigations we found a correlation between EEG abnormalities and GER. So we administered a combination of anticonvulsive and antacid therapy and, considering the total improvement of EEG, we diagnosed a neonatal form of "eating epilepsy".
    No preview · Article · Jul 2006 · International journal of immunopathology and pharmacology
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