Meta Analysis and Case review of Clinical, Neuro anatomical and Electrophysiological Characteristics of Patients with Musicogenic Epilepsy.
Hira Burhan1, Diji Johnson1, Rajesh Sachdeo1, Rahul Guha2, Alexander Buslov1, Marina Khrizman3, Rachel Penn4, Danish Shabbar1, Arun Antony2
1HMH Jersey Shore University Medical Center, 2Jersey Shore University Medical Center, 3K. Hovnanian Children'S Hospital At Jersey Shore University Medical Center, 4Jersey shore medical center
Objective:
To evaluate the clinical, neuro anatomical and electrophysiological characteristics of patients with musicogenic epilepsy.
Background:
Musicogenic epilepsy is a rare form of reflex epilepsy in which seizures are provoked by music. The literature for this is sparse, demanding more evidence on the etio-pathogenesis of musicogenic epilepsy and its associated clinical features.
Design/Methods:
The PubMed database was searched for studies that evaluated musicogenic epilepsy with the terms “musicogenic” AND “epilepsy” AND “seizure”. PRISMA flowchart was integrated in the selection of studies and data was analyzed using SPSS software. In addition to the literature reviewed in the meta-analysis, we also present a case review of a patient in our institution who was diagnosed with musicogenic epilepsy and underwent intracranial EEG evaluation.
Results:
Our search yielded ten studies of which seven, containing appropriate data, were included in the analysis. All studies indicated a very specific auditory trigger which had an emotional association with the patient’s past experience. All reported studies identified the involvement of the right temporal lobe, especially the hippocampus as a seizure onset zone. These findings were consistent with imaging studies (PET/SPECT) showing hyperperfusion in the temporal lobe. With the exception of one patient who also had concurrent spontaneous seizures originating from the left temporal lobe, epilepsy surgery achieved Engel Class 1 outcome in all cases.
Conclusions:
Musicogenic epilepsy is strongly associated with an auditory trigger with emotional attachment to the precipitating stimulus. The seizure onset zone in musicogenic epilepsy is the mesial or lateral temporal lobe. More studies are in demand to fully understand the etio-pathogenesis and the predictors of outcome of epilepsy surgery in musicogenic epilepsy.
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