Sudoku Seizures

A 25-year-old right-handed physical education student was buried by an avalanche during a ski tour, resulting in 15 minutes of hypoxia. He developed posthypoxic intention myoclonus with involuntary myoclonic jerks of the mouth induced by talking and of both legs by walking. Weeks later when trying to solve sudoku puzzles, he developed clonic seizures of the left arm (video 00:23) associated with a right centroparietal seizure pattern on EEG. The unilateral clonic seizures stopped immediately when the sudoku puzzle was discontinued. Hypoxia most likely caused diffuse, widespread damage and regional loss of right centroparietal U fibers (seen in diffusion tensor imaging) which resulted in impaired inhibition documented by giant somatosensory evoked potentials. Functional activation of the hyperexcitable region resulted in focal epileptic seizures. The patient stopped solving sudoku puzzles and became seizure free for over 5 years. Read the full case report at http://ja.ma/1jEArCp!