Interictal cerebral MRI scancoronal sectionsshowing the enlargement of the left amygdala (A) and hippocampus (B) on T1-inversion recovery pulse sequence, as well as FLAIR hyperintensities in the same regions [(C) amygdala; (D) hippocampus]. Open in a separate window Figure 4 EEG data displaying rhythmic ictal discharge over the left temporal leads spreading toward the suprasylvian and contralateral regions after the clinical onset (A); independent component analysis identified a theta discharge represented in the time domain name (B) and the frequency domain name (C); the dipole was localized in the left temporal neocortical region of patient’s cerebral MRI (3D view) (D); and cortical surface reconstructioncoronal (E) and sagittal (F) sections. Discussion The main differences between musicogenic and elementary stimulus audiogenic seizures involve the characteristics of epilepsy and the complexity of auditory triggers (15). the amygdala, the head, and the body of the hippocampus) and faced an Engel IA outcome 3 years Geraniol post-surgery. Mouse monoclonal antibody to Mannose Phosphate Isomerase. Phosphomannose isomerase catalyzes the interconversion of fructose-6-phosphate andmannose-6-phosphate and plays a critical role in maintaining the supply of D-mannosederivatives, which are required for most glycosylation reactions. Mutations in the MPI gene werefound in patients with carbohydrate-deficient glycoprotein syndrome, type Ib The second patient was diagnosed with autoimmune temporal lobe epilepsy (GAD-65 antibodies). Her seizures were triggered by contemporary hit radio songs without any personal emotional significance. Interictal and ictal video-electroencephalography (video-EEG) and impartial component analysis highlighted the left temporal lobe seizure onset extending over the neocortical regions. Intravenous immunoglobulin therapy was initiated, and the patient became seizure-free at 1 year. In conclusion, musicogenic seizures may be elicited by various auditory stimuli, the presence or absence of an emotional component offering an additional clue for the underlying network pathophysiology. Furthermore, in such cases, the use of impartial component analysis of the scalp EEG signals proves useful in revealing the location of the seizure generator, and our findings point toward the temporal lobe, both mesial and neocortical regions. Keywords: musicogenic epilepsy, temporal lobe, focal cortical dysplasia, anti-GAD, impartial component Geraniol analysis, ictal source localization Introduction Musicogenic epilepsy is a rare form of reflex epilepsy (1), with an estimated prevalence in the general population of 1 1 in 10 million people (2), in which seizures are provoked by music. Various etiologies have been reported such as focal cortical dysplasia (FCD) type I (3), astrocytoma (4), glial scars (5), demyelinating lesions (6), and autoimmune encephalitis (7). However, in most cases, a structural lesion could not be ascertained (5). The treatment of musicogenic seizures usually ranges from the avoidance of the musical triggers together with anti-seizure medication to epilepsy surgery (2). As there is emerging evidence of an association between musicogenic seizures and anti-glutamic acid decarboxylase antibodies (anti-GAD abs) encephalitis, the focus progressively shifts toward immunotherapy (8, 9). This article aimed to present two cases of musicogenic epilepsy of different etiologies (FCD type IIA and anti-GAD abs encephalitis) that involve the left or right temporal lobe, with their particularities of diagnosis and management of subsequent learning points. Geraniol Case 1 Case description A 30-year-old right-handed woman with a medical history of type 1 diabetes mellitus (DM), distal sensory diabetic polyneuropathy, Stargardt disease, nephrolithiasis, and anxiety-depressive disorder presented to our neurology department for recurrent epileptic seizures. She described her habitual diurnal episode as an ascending epigastric sensation (accounted for as fear), followed by complex visual hallucinations, nausea, and verbal automatisms. During the focal seizures that lasted up to 1 1 min, the patient maintained contact and exhibited facial cyanosis. She had no postictal deficit. The patient emphasized that listening to music triggered her diurnal seizures, particularly music that she liked. She had her first seizure at the age of 29 years. She was the result of an uneventful pregnancy and had normal psychomotor development. The patient had no history of cranial-cerebral Geraniol trauma, febrile convulsions, or neuro-infections. The neuropsychological examination was normal, but she had an anxiety-depressive disorder. As to her familial medical history, the only disorders mentioned were type 1 DM in one of her children and Stargardt disease in two of her children and her sister. At the moment of her presentation to our clinic, she was on levetiracetam (500 mg bd) and lamotrigine (100 mg bd), Geraniol but she was still experiencing daily seizures. Her longest seizure-free period was 2 months. Her general and neurological clinical examinations revealed severely reduced visual acuity in both eyes, particularly in the macular field. Diagnostic assessment Long-term video-EEG monitoring showed interictal epileptiform discharges during wakefulness and NREM sleep, predominantly in the right frontal-temporal leads (Fp2CF8, F8CT4, T4CT6, and TP10CPO10). Two reflex seizures were recorded within 15 s after listening to one song that she liked. Clinically, she alerted the medical personnel that she felt nauseous, and she touched her epigastric region with her left hand. During the first few seconds, she could answer and follow commands, but after that, she lost awareness and exhibited left upper limb and oral-alimentary automatisms. She also presented a postictal cough. Electrically, the seizures started in the right frontal-temporal leads (F8, T4, and FC6). The.