OPERCULAR MYOCLONIC-ANARTHRIC STATUS EPILEPTICUS

We report 3 cases of opercular myoclonic status epilepticus (OMASE), c haracterized by fluctuating cortical dysarthria without true aphasia a ssociated with epileptic myoclonus involving bilaterally the glossopha ryngeal musculature. In this syndrome, the inferior rolandic area of e ither one or the other hemisphere is involved by an epileptogenic lesi on of various etiology. Ictally, clonic expression was consistent with epilepsia partialis continua (EPC) and bilaterally and symmetrically involved palatal muscles (cases 1-3), tongue (cases 2 and 3), lips and chin (case 3), and inferior jaw (case 1) due to bilateral projections of the inferior corticonuclear pathways. Postictally, the main clinic al sign was pseudobulbar palsy, consistent with Todd's palsy. In our c ases, OMASE was either of vascular (cases 1 and 2) or tumoral origin ( case 3). In adulthood, early recognition of OMASE, although nonspecifi c, may be important for early management of carotid occlusive disease because it usually indicates an acute opercular infarction.