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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2018; 76(07): 495-496
DOI: 10.1590/0004-282X20180045
IMAGES IN NEUROLOGY

Dyshormia in focal epilepsy

Disormia em Epilepsia Focal
Mauricio F. Villamar
1   University of Kentucky Department of Neurology, Lexington, KY, USA.
,
Frank G. Gilliam
1   University of Kentucky Department of Neurology, Lexington, KY, USA.
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A 37-year-old man was evaluated for recurrent episodes of impaired awareness since childhood. EEG showed right temporal focal dyshormia ([Figure 1]). MRI revealed a right temporal mass ([Figure 2]).

Zoom Image
Figure 1 Electroencephalographic abnormalities in focal dyshormia. A) and B) Right temporal epileptiform K-complexes during N2 sleep (arrows).
Zoom Image
Figure 2 Neuroimaging showing a right temporal mass. A) coronal and B) axial non-contrast T2-FLAIR-weighted brain MRI shows a hyperintense right posterior temporal lobe lesion with heterogeneous internal signal (arrows). Pathology revealed a dysembryoplastic neuroepithelial tumor, WHO grade I.

Niedermeyer coined the term “dyshormia” to define epileptiform discharges that occur in conjunction with K-complexes on arousal from sleep[1]. Although dyshormia was originally described in generalized epilepsies[1], unilateral, focal dyshormia is occasionally seen in focal epilepsies[2].

In focal epilepsies, epileptiform discharges associated with K-complexes are typically ipsilateral to the epileptogenic zone, and are more common in frontal than in temporal lobe epilepsies[2]. Their presence can assist in localization of epileptogenic regions.


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Conflict of interest:

There is no conflict of interest to declare.

  • References

  • 1 Niedermeyer E. Epileptiform K complexes. Am J Electroneurodiagnostic Technol. 2008 Mar;48(1):48-51.
  • 2 Geyer JD, Carney PR, Gilliam F. Focal epileptiform spikes in conjuction with K-complexes. J Clin Neurophysiol. 2006 Oct;23(5):436-9. https://doi.org/10.1097/01.wnp.0000228499.92313.d6

Address for correspondence

Frank G. Gilliam
Department of Neurology, University of Kentucky; 740 S Limestone St.; Kentucky Clinic – J417; Lexington, KY, USA 40536-0298

Publication History

Received: 22 February 2018

Accepted: 25 March 2018

Article published online:
25 August 2023

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  • References

  • 1 Niedermeyer E. Epileptiform K complexes. Am J Electroneurodiagnostic Technol. 2008 Mar;48(1):48-51.
  • 2 Geyer JD, Carney PR, Gilliam F. Focal epileptiform spikes in conjuction with K-complexes. J Clin Neurophysiol. 2006 Oct;23(5):436-9. https://doi.org/10.1097/01.wnp.0000228499.92313.d6

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Zoom Image
Figure 1 Electroencephalographic abnormalities in focal dyshormia. A) and B) Right temporal epileptiform K-complexes during N2 sleep (arrows).
Zoom Image
Figure 2 Neuroimaging showing a right temporal mass. A) coronal and B) axial non-contrast T2-FLAIR-weighted brain MRI shows a hyperintense right posterior temporal lobe lesion with heterogeneous internal signal (arrows). Pathology revealed a dysembryoplastic neuroepithelial tumor, WHO grade I.