Mapping musical automatism: Further insights from epileptic high-frequency oscillation analysis

As ictal semiology is increasingly understood to arise from epileptogenic networks, high-frequency oscillation propagation patterns are helping elucidate networks relevant for surgical planning. Musical automatisms, a well-documented but very rare phenomenon of epilepsy, have yet to be examined as a manifestation of high-frequency propagation in the public literature. In our current study, we report a rare case intractable epilepsy with ictal humming whose epileptogenic zone was associated with the non-dominant left anterior medial temporal region. Mapping our case's ictal semiology and high-frequency propagation pattern both facilitated treatment and further supports prior observations that the rare phenomena of musical automatisms localize to a non-dominant frontal-temporal network rather than a specific cortical territory.