MUSICOGENIC EPILEPSY - REVIEW OF THE LITERATURE AND CASE-REPORT WITH ICTAL SINGLE-PHOTON EMISSION COMPUTED-TOMOGRAPHY

Purpose: We report a case of musicogenic epilepsy with ictal single ph oton emission computed tomography (SPECT) study and discuss the findin gs of this patient in the context of 76 cases with musicogenic epileps y described in the literature and seven other cases followed in Zurich . Methods: We analyzed the 83 patients according to the precipitating musical factors, type of epilepsy, presumed localization of seizure on set, and demographic data. Results: Fourteen of 83 patients (17%) had seizures triggered exclusively by music. At time of examination, music was the only known precipitating stimulus in 65 of 83 patients (78%). Various characteristics of the musical stimulus were significant, e.g ., musical category, familiarity, and instruments. Conclusions: Musico genic epilepsy is a particular form of epilepsy with a strong correlat ion to the temporal lobe and a right-sided preponderance. A high music al standard might predispose for musicogenic epilepsy. Moreover, the m ajority of cases do not fall into the category of a strictly defined ' 'reflex epilepsy,'' but appear to depend on the indermediary of a cert ain emotional reaction mediated through limbic mesial temporal lobe st ructures.