Favorable outcomes of epilepsy with gait-induced seizures after resection of the unilateral supplementary motor area

Satoshi Kodama; Naoto Kunii; Yuichiro Shirota; Takusei Chou; Mizuho Kawai; Seijiro Shimada; Meiko Maeda; Hiroyuki Ishiura; Masashi Hamada; Masako Ikemura; Yuko Saito; Naoki Akamatsu; Taira Uehara; Nobuhito Saito; Tatsushi Toda

doi:10.1016/j.cnp.2025.10.004

Back

Favorable outcomes of epilepsy with gait-induced seizures after resection of the unilateral supplementary motor area

Journal article

Open access

Peer reviewed

Favorable outcomes of epilepsy with gait-induced seizures after resection of the unilateral supplementary motor area

Satoshi Kodama, Naoto Kunii, Yuichiro Shirota, Takusei Chou, Mizuho Kawai, Seijiro Shimada, Meiko Maeda, Hiroyuki Ishiura, Masashi Hamada, Masako Ikemura, …

Clinical neurophysiology practice, Vol.10, pp.489-492

01/01/2025

DOI: 10.1016/j.cnp.2025.10.004

PMID: 41229395

Files and links (1)

url

https://doi.org/10.1016/j.cnp.2025.10.004View

Published (Version of record) Open Access

Abstract

•The patient had gait-induced seizures, a rare type of reflex epilepsy.•Intracranial EEG revealed onset in the supplementary motor area.•Resection led to seizure freedom, implicating gait-related motor networks. Gait-induced seizures are a rare manifestation of reflex epilepsy. Pathophysiology of this phenomenon has not been fully understood. A 28-year-old woman presented with a long history of “falls” following paroxysmal bilateral leg stiffness triggered by walking. Scalp electroencephalogram (EEG) revealed low-amplitude rhythmic beta activity, maximal at the Cz electrode, during these events. Magnetoencephalography demonstrated repetitive sharp waves source-localized to the right primary motor cortex. Multiple anti-seizure medications failed to improve her symptoms; however, the clinical manifestation was consistent with epilepsy with gait-induced seizures. Intracranial subdural EEG recording was performed and confirmed ictal activity originating from the right supplementary motor area. Resection of this area resulted in complete resolution of her symptoms. This is the first reported case of successful resective surgery for epilepsy with gait-induced seizure. Brain networks involving cortical regions responsible for the initiation or execution of walking presumably played a key role in the generation of gait-induced seizures. Careful assessment using non-invasive neurophysiological studies facilitated accurate diagnosis, successful intracranial recordings, and effective resective surgery.

Electrocorticogram

Intracranial electroencephalogram (EEG)

magnetoencephalogram (MEG)

Reflex epilepsy

SMA

Details

Title: Subtitle: Favorable outcomes of epilepsy with gait-induced seizures after resection of the unilateral supplementary motor area
Creators: Satoshi Kodama - University of Iowa Hospitals and Clinics
Naoto Kunii - Jichi Medical University
Yuichiro Shirota - The University of Tokyo
Takusei Chou - The University of Tokyo
Mizuho Kawai - The University of Tokyo
Seijiro Shimada - The University of Tokyo
Meiko Maeda - The University of Tokyo
Hiroyuki Ishiura - Okayama University
Masashi Hamada - The University of Tokyo
Masako Ikemura - The University of Tokyo
Yuko Saito - Tokyo Metropolitan Institute of Gerontology
Naoki Akamatsu - International University of Health and Welfare
Taira Uehara - International University of Health and Welfare
Nobuhito Saito - The University of Tokyo
Tatsushi Toda - The University of Tokyo
Resource Type: Journal article
Publication Details: Clinical neurophysiology practice, Vol.10, pp.489-492
DOI: 10.1016/j.cnp.2025.10.004
PMID: 41229395
NLM abbreviation: Clin Neurophysiol Pract
ISSN: 2467-981X
eISSN: 2467-981X
Publisher: Elsevier B.V
Number of pages: 4
Language: English
Date published: 01/01/2025
Academic Unit: Neurology
Record Identifier: 9985177940102771

Metrics

2 Record Views