[Rotatory seizures: a rare equivalent of focal epileptic activity. Case report and possible pathophysiology]

We report a typical case of so called "volvular epilepsy" (synonym: retatory seizures, circling epilepsy). Our 59-year-old patient exhibited the characteristic pattern of repetitive walking in small circles, always strictly contralateral to the epileptogenic focus in the right fronto-parietal region. The MRI study indicated a diagnosis of brain tumor in the same area, which was confirmed as an oligodendroglioma. After adequate anticonvulsive treatment there was complete seizure control. Rotatory seizures are rarely reported and usually related to pathological findings in the fronto-temporal region (infarction, neoplasma, giant aneurysm and posttraumatic lesions). Corresponding to the international classification of epileptic seizures, this is a very rare manifestation of a simple partial seizure (without impairment of the conscious state), which can extend to a complex partial seizure (with impairment of consciousness) and secondarily generalized tonic-clonic seizure. In explaining this rare epileptic phenomenon, the controversial concepts (involvement of the striatum, temporal lobe or cortical adverse fields?) are discussed.