Metabolic imaging correlate of truncal onset seizures.

OBJECTIVE To denote the metabolic imaging localization of seizure onset with ictal and interictal Neurolite single-photon emission computed tomographic scans and difference images made by subtracting activity at individual voxels of these images, which ultimately identify intense focal uptake in the trunk motor region and other, probably secondarily, propagated pathways. DESIGN Retrospective review of a unique case report. SETTING A suburban epilepsy referral center. PATIENT A 59-year-old man with truncal-onset seizure. INTERVENTIONS Ictal and interictal metabolic imaging. MAIN OUTCOME MEASURES Onset location of ictal events. RESULTS The patient had a gliotic lesion in a focal region on magnetic resonance imaging undercutting the trunk motor area in the cortex of the precentral gyrus with concordant single-photon emission computed tomographic imaging. CONCLUSIONS While truncal-onset seizures have been described previously in a few case reports, they are clinically rare. As far as we know, this is the only case report in the literature in which metabolic imaging was carried out with this entity and is consistent with the anatomical localization of seizure onset in the trunk motor area.