Neurophysiol Clin 1999 ; 29 : 263-70 © Elsevier, Paris Article original Facial reflex myoclonus induced by language: a neuropsychological and neurophysiological study F. Bartolomei l*, G. Famarier 3, Z. Elias 4, G. Bronsard 2, S. Soulayrol 2, A. Bonnet 2, B. Chave 2, J.L. Gastaut 12 t Centre Saint-Paul spdcialis~ clans l'rpilepsie ; 2service de neurologie, hOpital Sainte-Marguerite Marseille ; 3service d' explorations fonctionnelles, hOpital Nord Marseille ; 4service de neurologie CHU de Toulouse, Toulouse, France (Received 9 February 1998; accepted 20 July 1998) Summary -We studied a 53 year old right-handed patient who presented isolated myoclonus of right facial muscles induced exclusively by language. Twitching significantly hindered speaking and reading performance. MRI and CT-scan revealed no brain lesion. Conventional EEG showed a few spike-waves predominantly in the left hemisphere. Spike-waves increased during drowsiness. An EEG-EMG polygraphic study was performed during stimulation tests which included linguistic tasks and non-verbal/non-linguistic tests. Myoclonus was triggered by speaking and writing but not by non-linguistic tasks. The severity of myoclonus was dependent on the complexity of the language task. Back-averaging of right facial EMG bursts failed to show a reliable EEG-EMG correlation. However, the facial reflex myoclonus might have originated from the left rolandic- opercular cortex, as it was triggered by complex language activities. Findings in this case are compared with those reported for other forms of reflex seizure and myoclonus. © Elsevier, Paris cortical myoclonus / epilepsy / language / motor cortex / reflex seizures R~sum~ - Myoclonies faciales ii~es au langage : une ~tude neuropsychologique et neurophysiologique. Les auteurs ont 6tudi6 le cas d'un homme ~g6 de 53 ans qui pr~sentait des myoclonies de l'h~miface droite d~clenchres uniquement par les activit~s lires au langage. Ces secousses g~naient considrrablement le malade quand il parlait ou lisait. Aucune cause ne f~t retrouv~e, en particulier les examens neuroradiologiques (scanner crr~bral, IRM crr~brale) 6taient normaux. Sur I'EEG il existait de rares pointe-ondes diffuses, predominant sur l'hJmisphbre gauche. Une ~tude polygraphique EMG-EEG f~t rJalis~e alors que le patient ~tait 6valu~ sur les diff~rentes modalitds du langage et par des 6preuves non linguistiques. Les myoclonies faciales ~taient drclench~es par le langage oral et 6crit, mais par aucune des ~preuves non linguistiques (notamment visuospatiales). La fr~quence des myoclonies 6tait d~pendante de la complexitd des ~preuves de langage. Une ~tude en ~<back averaging~> ~ partir d'un moyennage des myoclonies n 'a pas mis en ~vidence de corr~lat cortical clair ?tces myoclonies. N~anmoins, certains arguments plaident en faveur d'un myoclonus originaire de la r~gion * Correspondence and reprints: laboratoire de neurophysiologie et neuropsychologie, CJF Inserm 9706, facult6 de m6decine Timone, 27, boulevard Moulin, 13385 Marseille, France.