Case Report: Ictal hypersalivation: a stereoelectroencephalography exploration

TL;DR

This case report explores a rare seizure symptom of excessive salivation and its successful treatment using brain monitoring and targeted therapy.

Contribution

The study presents a novel application of SEEG-guided RFTC for treating seizures characterized by hypersalivation.

Findings

The patient's seizures were characterized by hypersalivation, pill-rolling movements, and lip-smacking.

The patient became seizure-free after SEEG-guided radiofrequency thermocoagulation.

SEEG helped identify the brain region responsible for triggering excessive salivation during seizures.

Abstract

Epilepsy is a chronic neurological condition with various etiologies, and recurrent unprovoked seizures characterize it. Hypersalivation is a recognized symptom of insular-opercular epilepsies. A wide range of symptoms can occur during a seizure, including hypersalivation, autonomic responses, oropharyngeal sensations, visceral sensations, somatosensory disturbances, and emotional manifestations. In this case study, we examine a unique scenario of a patient who experienced predominantly salivary seizures. Hypersalivation, pill-rolling movements, and lip-smacking characterized these seizures. Importantly, the patient became seizure-free after undergoing radiofrequency thermocoagulation (RFTC) with the assistance of Stereoelectroencephalography (SEEG). Our discussion will focus on the treatment approach involving SEEG-guided RFTC and the careful identification of the brain cortex responsible for triggering excessive salivation during seizures.

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