A 52-year-old right-handed woman taking dimethyl fumarate (Tecfidera) as disease-modifying treatment for relapsing-remitting multiple sclerosis (MS), presented with a two-week history of frequent, brief episodes of intermittent tongue twitching lasting up to one minute. There was a prodrome of an ‘electric feeling’ spreading across the hard palate. She could not talk or swallow during the episodes, but there was no impaired awareness. She was admitted to hospital when two witnessed nocturnal generalised tonic-clonic seizures occurred within a 24-hour period. Episodes recorded on her smartphone were consistent with left-sided lingual and lower facial clonic movements (see online supplemental video, figure 1). These resolved after starting levetiracetam 750 mg two times per day.### Supplementary video [pn-2023-004020supp001.mp4] Figure 1 Self-recorded stereotyped left-sided lingual and lower facial clonic movements (see online supplemental video). MR scan of brain with gadolinium contrast identified no new or enhancing lesions but showed a …

中文翻译：

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额叶皮质脱髓鞘所致的舌癫痫

一名 52 岁的右利手女性服用富马酸二甲酯 (Tecfidera) 作为复发缓解型多发性硬化症 (MS) 的疾病缓解治疗，出现两周频繁、短暂的间歇性舌头抽搐病史，持续时间长达等一下。有一种“电击感”的前驱症状在硬腭中蔓延。发作期间她无法说话或吞咽，但意识没有受损。当两次目睹 24 小时内发生夜间全身性强直阵挛性癫痫发作时，她被送往医院。她的智能手机上记录的事件与左侧舌和下面部阵挛运动一致（参见在线补充视频，图 1）。开始每天两次服用左乙拉西坦 750 毫克后，这些问题得到解决。### 补充视频 [pn-2023-004020supp001.mp4] 图 1 自我记录的刻板左侧舌和下面部阵挛运动（请参阅在线补充视频）。使用钆造影剂对大脑进行 MR 扫描，没有发现新的或增强的病变，但显示……