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Epilepsy Review > Seizure Localization > Flashcards

Seizure Localization Flashcards

1
Q

Somatosensory phenomenon:

  • Jacksonian March
  • Well Defined
  • Slow spread
A

(mostly CL)

Primary somatosensory area (Parietal lobe)

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2
Q

Somatosensory phenomenon: Ill defined, may be accompanied by pain. Fast spread

A

(IL or CL)
Supplementary somatosensory
- Posterior Insula
- Parietal operculum

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3
Q
  • Diffuse contralateral or Bilateral tingling

- Sensation of movement

A

Supplementary Motor Area

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4
Q
  • Cephalic sensation

- Nonvertiginous Dizziness

A

(often) frontal lobe

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5
Q
  • Ictal Headache
A

(IL)

Temporal or Occipital

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6
Q

Gustatory Aura (metalic / rubbery)

A
  • Insula
  • Rolandic Operculum
  • Parietal
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7
Q

Elementary Auditory

A

(CL)

- Contralateral primary auditory cortex

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8
Q

Olfactory Aura

A

Anterior mesial temporal (“uncinate fits”)

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9
Q

Visual aura

A

Contralateral Occipital

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10
Q

Ictal Blindness

A

Contralateral occipital

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11
Q

Deja vous / Jamais vou

A

Mesiotemporal (w/o lateralization)

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12
Q

Forced thinking: more verbal

A

Dominant frontal

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13
Q

Forced thinking: more emotional

A

Dominant mesiotemporal

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14
Q

Ictal Fear

A

Amygdala or Cingulate

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15
Q

Ecstatic Aura

A

Amygdala or Cingulate

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16
Q

Orgasmic Aura

A
  • Non-Dominant Mesiotemporal

- Parasaggital

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17
Q

initial autoscopy (“out of body” sensation)

A

Non-dominant parietal

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18
Q

Forced Head turn (>5 sec)

A

94% PPV CL (mostly temporal or frontal)

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19
Q

Head turn: early, non-forced)

A

IL

  • Temporal
  • Basal Ganglia
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20
Q

Head / Eye deviation AFTER GTC

A

typically Ipsilateral

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21
Q

“Y sign”

A

SSMA or SMA

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22
Q

Tonic Seizure

A

often frontal lobe (medial SMA)

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23
Q

Gyratory Seizures with forced head turn

A

CL frontotemporal

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24
Q

Gyratory Seizure with en bloc version

25
Q

Gyratory seizure with rotation to prone

26
Q

Ictal smile

A

non-dominant parietal

27
Q

ictal pouting (chapeau de gendarme)

A
  • Mesial frontal

- Angulate cingulate

28
Q

Behavioral arrest

A
  • Temporal

- Orbitofrontal

29
Q

Bizarre behavior

A

Orbitofrontal

30
Q

Automatisms: manipulative unilateral limb

A

Ipsilateral

31
Q

Automatisms: proximal, non-manipulative

A

Contralateral temporal

32
Q

Oral automatisms (lip smacking, chewing, sucking, swallowing)

A
  • Temporal
  • inferomedial
  • hippocampal
33
Q

Automatisms: bipedal

34
Q

Ictal cough

35
Q

postictal cough

A

non-dominant

36
Q

Ictal eyeblinks: unilateral

A

Ipsilateral

37
Q

Ictal eyeblinks: Bilateral

38
Q

Gelastic

A
  • Hypothalamic
  • Mesial temporal
  • Frontal cingulate
39
Q

Ictal crying / weeping (Dacrystic seizures) w/o gelastic component

A
  • Non-dominant mesiotemporal

- Non-dominant mesial frontal

40
Q

Ictal crying / weeping (Dacrystic) WITH gelastic component

A

hypothalamic

41
Q

Genital aura

A

Ipsilateral

42
Q

Ictal nystagmus

A

CL frontal / Occipital

43
Q

Ictal spitting

A

Non-dominant temporal

44
Q

postictal nose wiping

A

IL temporal (90% PPV)

45
Q

Ictal / postictal drinking

A

Non-dominant temporal

46
Q

Ictal tachycardia

A

No localization

47
Q

Ictal bradycardia / asystole

A

Temporal&raquo_space; frontal

48
Q

Ictal Dyspnea

A

links to insula

49
Q

ictal urinary urge

A

non-dominant temporal

50
Q

Ictal emesis

A
  • Non-dominant temporal / anterior insula

- Benign occipital (Panayiotopoulos syndrome)

51
Q

piloerection

A

IL (often dominant) temporal

52
Q

Ictal Vertigo

A

Insular-temporal-parietal junction

53
Q

Epigastric rising

A

Temporal > orbitofrontal > Cingulate

54
Q

Ictal speech arrest / Jargon

A

Dominant Temporal

55
Q

postictal dysphasia / aphasia

A

Dominant Temporal

56
Q

PRESERVED SPEECH during seizure

A

Non-dominant temporal

57
Q

Guttural vocalizations

A

frontal lobe (orbitofrontal or parasagittal)

58
Q

Ictal humming / singing

A

Poorly lateralized

  • temporal lobe
  • pre-frontal cortex

Epilepsy Review (2 decks)

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