Differences of cortical activation in spontaneous and reflex myoclonias

Frontal and parietal components of somatosensory evoked potentials (SEPs) following median nerve stimulation and scalp potentials preceding myoclonic jerks (jerk-locked averaging, JLA) were compared in 6 patients with cortical reflex myoclonus. Giant potentials were found over the parietal cortex in both conditions. Prominent frontal activity was detected following median nerve stimulation which, however, was absent in jerk-locked averages. Therefore an identical generator of the giant SEP and the JLA is unlikely. As the frontal component is lacking in jerk-locked averaging, the spontaneous jerks produced in our experimental paradigm are believed to be due to spontaneous hyperactivity of the parietal cortex rather than to pathologically enhanced transcortical reflexes.