Hyperperfusion of anterior cingulate gyrus in a case of paroxysmal nocturnal dystonia

The authors report the clinical, EEG, and SPECT findings of a patient with nocturnal paroxysmal dystonia. Ictal and interictal scalp EEG showed epilep tiform. activity over both frontal lobes. Subtraction ictal SPECT co-regist ered to MRI indicated a bilateral significant hyperperfusion in the anterio r part of the cingulate gyrus. These results support earlier electrophysiol ogic investigations by others suggesting that anterior cingulate epilepsy m ay manifest as nocturnal paroxysmal dystonia, and illustrate the usefulness of computer-assisted SPECT analysis.