Absence of an Autonomic Sign Assists in the Diagnosis of Extratemporal Lobe Epilepsy Manifesting Generalized Convulsion with Retained Awareness

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Author(s)

    • Neshige Shuichiro
    • Department of Neurology, Kyoto University Graduate School of Medicine, Japan|Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
    • Matsumoto Riki
    • Department of Neurology, Kyoto University Graduate School of Medicine, Japan
    • Inouchi Morito
    • Department of Neurology, Kyoto University Graduate School of Medicine, Japan
    • Kobayashi Katsuya
    • Department of Neurology, Kyoto University Graduate School of Medicine, Japan
    • Shimotake Akihiro
    • Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Japan
    • Maruyama Hirofumi
    • Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
    • Takahashi Ryosuke
    • Department of Neurology, Kyoto University Graduate School of Medicine, Japan
    • Ikeda Akio
    • Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Japan

Abstract

<p>We herein report two epilepsy patients with the seizure focus in the non-dominant hemisphere manifesting secondarily generalized convulsion (sGC) with retained awareness characterized by a lack of autonomic signs although GC was complicated by respiratory arrest. Given the semiology and electrophysiological findings, the seizure activity was considered to propagate to the supplementary-motor area and the bilateral primary-motor area, with a clinical manifestation of sGC. The absence of autonomic signs during GC can be a key indicator that the seizure remains in the bilateral suprasylvian area and thus does not involve the region necessary for awareness preservation, which may assist in the diagnosis of this atypical epileptic seizure. </p>

Journal

  • Internal Medicine

    Internal Medicine 58(8), 1151-1155, 2019

    Japanese Society of Internal Medicine

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