Studio video-poligrafico e di fRM in un caso di epilessia musicogenica

Objective: To describe a case of musicogenic epilepsy with seizures triggered by a specific song. Method: A 36-year-old right-handed man, has had frequent seizures with ascending gastric sensation, tachycardia and oro-alimentary-automatisms since the age of 24 years. All the seizures were musicogenic appearing every time the patient listened to music, namely melodies with a strong emotional charge (i.e. Anastasia's song "Overdue Goodbye"). The patient underwent video-polygraphic recording and brain fMRI study during which he listened both "neutral" and "emotionally charged" music. Results: Video-polygraphic recordings documented three right temporal seizures, all triggered by listening to "emotionally charged melody" (ECM), whereas neutral songs (NS) were ineffective. The seizures were preceded by an increase in heart rate and blood pressure. The fMRI study showed activation in right acoustic areas during "NS" while "ECM" provoked a widespread activation over the right fronto-temporo-occipital area before the seizure beginning. Conclusions: Our results support the role of the right temporal lobe in this kind of epilepsy and show that the cerebral areas activated during the emotional status leading to the seizures encompass the auditory cortex activated by neutral music.