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

• 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

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.

Journal

• Internal Medicine

  Internal Medicine 58 (8), 1151-1155, 2019-04-15

  The Japanese Society of Internal Medicine

Keywords

• generalized
• consciousness
• autonomic symptoms
• non-dominant hemisphere
• insula

Details

• CRID: 1390845713060592768
• NII Article ID: 130007632754
• DOI: 10.2169/internalmedicine.1740-18
• ISSN: 13497235
• ISSN: 09182918
• HANDLE: 2433/241268
• PubMed: 30568140
• Web Site: https://www.jstage.jst.go.jp/article/internalmedicine/58/8/58_1740-18/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2020189978
• Text Lang: en
• Data Source:
  • JaLC
  • IRDB
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed