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Ictal singing has been rarely reported and the neural networks underlying this specific symptom remain unknown. We report a nineteen-year-old man with medically refractory seizures who exhibited ictal singing and laughing. He underwent intracranial stereotactic EEG recording which demonstrated ictal activity in medial and dorsolateral regions of the left frontal lobe in the generation of ictal singing. Thereafter, a left frontal resection of the superior and middle frontal gyri made him seizure-free. Among the previously reported cases of ictal singing, the symptomatogenic zones included bilateral frontal and temporal lobes. The wide variance of ictal onset zones suggests that the mechanism of ictal singing is probably related to the recruitment of music-related neural networks in different regions of both hemispheres rather than activation of a specific cortical region., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Refractory status epilepticus is a devastating persistent seizure state with a poor prognosis that requires emergency medical management. Recent studies have reported de novo, idiopathic refractory status epilepticus of unclear etiology in healthy young patients followed by severe neurologic sequelae. We present a series of 7 cases of de novo sustained refractory status epilepticus. We found that all patients were young and previously healthy and that, prior to the onset of refractory status epilepticus, all had prodromal viral-like symptoms. The onset of refractory status epilepticus was explosive and intractable, resulting in prolonged hospital stay and dependence on multiple antiepileptic medications. Clinical outcome was poor in all 7 patients. The laboratory findings suggest a possible immune activation that can have persisted in the nervous system after a nonspecific infection. We report on these patients so as to raise awareness of this unique entity to facilitate early diagnosis and treatment.

An Arabidopsis thaliana mutant (mur1) has less than 2 percent of the normal amounts of L-fucose in the primary cell walls of aerial portions of the plant. The survival of mur1 plants challenged the hypothesis that fucose is a required component of biologically active oligosaccharides derived from cell wall xyloglucan. However, the replacement of L-fucose (that is, 6-deoxy-L-galactose) by L-galactose does not detectably alter the biological activity of the oligosaccharides derived from xyloglucan. Thus, essential structural and conformational features of xyloglucan and xyloglucan-derived oligosaccharides are retained when L-galactose replaces L-fucose.