{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:52:46Z","timestamp":1789185166726,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T00:00:00Z","timestamp":1732233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This case report shows the importance of multimodal evaluation to formulate a proper diagnosis of negative motor seizures (NMSs). Only few reports in literature document NMSs with video\u2010electroencephalographic (EEG) and electromyographic coregistration. A multimodal evaluation is crucial to exclude common mimics and propose correct therapy. We describe a case of a 62\u2010year\u2010old man with drug\u2010resistant focal epilepsy and NMSs, evaluated with video\u2010EEG recording with polygraphy, magnetoencephalography (MEG), and brain magnetic resonance imaging (MRI). Video\u2010EEG monitoring showed 182 focal NMSs, with preserved awareness and comprehension. The patient reported complex paresthesia of the left hand followed by left facial grimace, left arm flaccid paralysis, and bradycardia. EEG showed ictal discharges in the right frontocentral region associated with sudden electromyographical silence in left limb muscles consistent with loss of tonic contraction from distal to proximal muscles of the arm. MEG localized the epileptic zone in the right opercular region, consistent with MRI evidence of type II cortical dysplasia in the right inferior frontal gyrus. Multimodal evaluation is essential to document the temporal relationship between ictal discharges, clinical onset of limb paresis, and electrophysiologic evidence of loss of tonic muscular contraction. It allows definition of the specific cortical area involved in NMSs, offering new insight into physiological brain functioning.<\/jats:p>","DOI":"10.1111\/epi.18191","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T14:40:13Z","timestamp":1732286413000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Focal negative motor seizures: Multimodal evaluation"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4202-955X","authenticated-orcid":false,"given":"Roberta","family":"Di Giacomo","sequence":"first","affiliation":[{"name":"Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4380-107X","authenticated-orcid":false,"given":"Rachele","family":"Colombo","sequence":"additional","affiliation":[{"name":"Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"},{"name":"Neuroscience Research Center, Department of Biomedical and Clinical Sciences University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5385-761X","authenticated-orcid":false,"given":"Laura","family":"Canafoglia","sequence":"additional","affiliation":[{"name":"Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dunja","family":"Duran","sequence":"additional","affiliation":[{"name":"Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Pastori","sequence":"additional","affiliation":[{"name":"Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0999-215X","authenticated-orcid":false,"given":"Andrea","family":"Stabile","sequence":"additional","affiliation":[{"name":"Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7496-2083","authenticated-orcid":false,"given":"Giulia","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4812-6310","authenticated-orcid":false,"given":"Giuseppe","family":"Didato","sequence":"additional","affiliation":[{"name":"Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Cuccarini","sequence":"additional","affiliation":[{"name":"Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0808-3042","authenticated-orcid":false,"given":"Francesco","family":"Deleo","sequence":"additional","affiliation":[{"name":"Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambra","family":"Dominese","sequence":"additional","affiliation":[{"name":"Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7443-6737","authenticated-orcid":false,"given":"Marco","family":"de Curtis","sequence":"additional","affiliation":[{"name":"Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Rossi Sebastiano","sequence":"additional","affiliation":[{"name":"Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"1023","volume-title":"Textbook of Epilepsy Surgery","author":"Smyth P","year":"2008"},{"key":"e_1_2_10_3_1","first-page":"297","volume-title":"Surgical treatment of the epilepsies","author":"L\u00fcders H","year":"1987"},{"key":"e_1_2_10_4_1","first-page":"115","article-title":"Cortical electrical stimulation in humans. 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