AccScience Publishing / AN / Online First / DOI: 10.36922/an.8353
CASE REPORT

Refractory musicogenic epilepsy and a surgical cure guided by metabolic neuroimaging: A case report

Joel M. Oster1* G. Rees Cosgrove2
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1 Department of Neurology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, United States of America
2 Department of Neurosurgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
Advanced Neurology, 8353 https://doi.org/10.36922/an.8353
Submitted: 31 December 2024 | Revised: 5 February 2025 | Accepted: 11 March 2025 | Published: 9 April 2025
(This article belongs to the Special Issue Advances in the pathogenesis, diagnosis and treatment of epilepsy)
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

A 40-year-old female patient with refractory musicogenic epilepsy and non-lesional magnetic resonance imaging neuroimaging is highlighted in this report. A right temporal lobectomy was necessary and sufficient to effect a durable surgical cure without recurrence for over approximately 18 years in follow-up while remaining off seizure medications for the prior 16 years. Our case report delineates that this patient was cured with a surgical resection guided by metabolic neuroimaging. This patient was evaluated for cerebral localization of seizure onsets to guide further therapy in an epilepsy center and the evaluation for localization of seizure onset identified that Ictal single photon emission computed tomography (SPECT) imaging identified an approximately 25% increase in blood flow or metabolism in the right temporal lobe during seizures compared with the baseline. Seizure semiology and electroencephalography localization were concordant with SPECT localization.

Keywords
Intractable epilepsy
Metabolic neuroimaging
Non-lesional epilepsy
Surgery
Funding
None.
Conflict of interest
The authors have no conflict of interests to declare.
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Advanced Neurology, Electronic ISSN: 2810-9619 Print ISSN: 3060-8589, Published by AccScience Publishing