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Angiographic changes in focal motor epilepsy

SUMMARYThe angiographic findings in 23 cases of focal motor epilepsy without obvious cause have been presented. In 16 of these there were found to be occlusions of small branches to the motor or premotor areas or both. Neurological abnormalities were present in all these cases; most of the patients were in the older age group. A distinct and previously unreported abnormality was found in 7 patients in which no occlusions were present but an artery supplying the motor area was vestigial in appearance. These individuals had no neurological deficit and, for the most part, no other abnormal findings. All occurred in a younger age group; there was one 10-year-old boy and the other 6 were from 20 to 34 years of age at the onset of symptoms. While the precise mechanism by which the small artery and focal motor seizures are related is not clear, the vascular changes are sufficiently characteristic to allow an angiographic diagnosis.