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• Vol.41 No.11
• CLINICA NEUROL, 41: 809−812, 2001
• Vol.41 No.11 contents

Case Report

A case with left mesial temporal lobe epilepsy characterized by abnormal massive salivation

Masayo Morita, M. D. ¹⁾ , Akira Kurita, M. D. ¹⁾ , Kiyoharu Inoue, M. D. ¹⁾ , Hiroyuki Shimizu, M. D. ²⁾ , Toshio Mizutani, M. D. ³⁾ and Nobutaka Arai, M. D. ⁴⁾

¹⁾Department of Neurology, Jikei University School of Medicine
²⁾Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital
³⁾Department of Pathology and Laboratory Medicine, Tokyo Metropolitan Neurological Hospital
⁴⁾Department of Clinlcal Neuropathology, Tokyo Metropolitan Institute for Neurosciense

A 26-year-old woman was admitted because of a 12-year history of intractable epileptic seizures. Every seizure began with an upper abdominal discomfort, and offen followed by massive salivation. Whenever the epileptic salivation happened, the patient lost consciousness, and sometimes she developed generalized convulsions. Interictal sphenoidal EEG recordings revealed abnormal discharges in the left mesial temporal region. MRI demonstrated left hippocampal atrophy. Since her seizures were medically intractable, left temporal lobectomy was performed. Neuropathologic examination revealed hippocampal sclerosis. After the operation, she became completely seizure-free with no episode of massive salivation.
From the literature, epileptic salivation can originates from the rolandic area; fronto-orbital cortex & cingulate gyrus; insula & operculum; and mesial temporal structures. The abnormal massive salivation in our patient might be attributable to the activation of frontal limbic system triggerd by hippocampal abnormal firing duing the ictal period of TLE.

(CLINICA NEUROL, 41: 809−812, 2001)
key words: abnormal massive salivation, complex partial seizure, temporal lobe epilepsy, hippocampus, frontal limbic system

(Received: 16-Jan-01)