Musicogenic epilepsy in adults: Epileptogenesis and management update [Epilepsia musicogénica no adulto: Epileptogénese e atualização da sua abordagem]

• Type: Article in National Scientific Journal
• Date: 2021

Authors

Francisco, L (Author) Other; Marta Carvalho (Author) FMUP

Journal

Title: Sinapse

Vol. 21

Pages: 85-92

ISSN: 1645-281X

Publisher: Sociedade Portuguesa de Neurologia

Indexing

Scopus - 0 Citations

Other information

Authenticus ID: P-00V-QK2

DOI: 10.46531/sinapse/ar/210028/2021

Abstract (EN): Musicogenic epilepsy (ME) is a rare form of reflex epilepsy in which seizures are triggered by exposure to musical stimuli, in particular, those with high emotional content. Despite rare and still very unknown, this disease can be very limiting and easily underdiagnosed. It is therefore important to increase clinicians¿ knowledge about ME, enabling better management of these patients. The objective of this critical narrative review of the literature is to systematize what is known about musicogenic epilepsy in adults, highlighting the epileptogenic mechanisms and the updates in clinical management. The included articles were selected through the PubMed database with the query ¿(¿Musicogenic¿) AND ¿Epilepsy¿[Mesh])¿. The estimated prevalence of ME is 1:1 000 000, with a slight female predominance. The mean age of onset is 28 years old (range: 2¿67 years). The role and characteris-tics of auditory stimuli as triggers for seizures are variable and highly individualized, ranging from simple tones to complex music, and from loud, non-musical sounds to stimuli that are low in volume. The reported cases vary widely regarding the degree of musical training of the patients, occurring in professional musicians as well as in patients with no musical background at all. Seizures¿ onset zone is mostly located in the temporal lobe, with right-sided predominance. However, some concomitant emotional processing areas are also involved in ME, such as limbic structures, the nucleus accumbens, and the orbitofrontal and prefrontal cortex. The pathophysiology of ME has similarities with comorbid affective disorders, such as depression and anxiety dis-orders, supporting the involvement of affective networks in the development of ME. Recently there are reports of musicogenic reflex seizures in patients with antiGAD en-cephalitis. Therefore, all patients with ME should be screened for this pathology, since an earlier diagnosis will result in more effective treatment and a better prognosis. The treatment of musicogenic epilepsy includes some non-pharmacological approaches, and antiepileptic drugs in most cases, rarely culminating in surgery. Despite being a rare disease, ME should be easily diagnosed and treated to re-duce the repercussions in patients¿ life. © Author(s) (or their employer(s)) and Sinapse 2021.

Language: English

Type (Professor's evaluation): Scientific