Musicogenic epilepsy with ictal single photon emission computed tomography(SPECT): could these cases contribute to our knowledge of music processing?

Musicogenic epilepsy nas a strong correlation with the temporal lobe with a right-sided preponderance. We report the case of a 48-year-old woman whose seizures began at the age of 32 years. Her prenatal, natal and childhood h istories were unremarkable and her family history was negative for epilepsy . She had typical complex partial seizures with chewing automatisms. Crania l computed tomography, magnetic resonance imaging (MRI) and interictal SPEC T showed no abnormality. Interictal EEG showed paroxysmal bitemporal sharp wave discharges predominant on the right side. Ictal EEG showed a combinati on of high voltage sharp and slow sharp waves and spikes that originated fr om the right temporal leads and then became generalized. Ictal activity on EEG started 4-5 min after the music stimulus. For the ictal SPECT study, i. v. injection of 20 mCi of HMPAO was administered approximately 30 s after t he ictal activity started. Ictal SPECT demonstrated a right anterior and me sial temporal hyperperfusion. These results seem to support the dominant ro le of the right temporal lobe and the possible relation of mesial temporal structures to the affective content of music in musicogenic epilepsy.