Seizure Semiology Flashcards
Common viscero sensory aura associated with temporal lobe epilepsy
Rising epigastric sensation
Common cognitive phenomena associated with temporal lobe epilepsy
Fear, déjà vu, jamais vu, visceral and auditory illusions, complex auditory or visual hallucinations
An abrupt, explosive seizure onset is likely attributable to which lobe of the brain?
Frontal
Postictal dysphasia in temporal lobe epilepsy lateralizes to which hemisphere?
dominant hemisphere
Post-ictal amnesia is a sign of
bilateral hippocampal impairment
Dacrystic seizure localization
Temporal, hypothalamic
Ictal/postictal speech impairments can be lateralized to
Language-dominant hemisphere
Postictal nose wipe can be lateralized and localized to
ipsilateral hemisphere in patients with temporal lobe epilepsy
Where do complex visual hallucinations localize to?
Visual association cortex
Cognitive features such as Déjà vu, and jamais vu, and emotional features such as panic and fear are common in what type of focal seizures?
mesial temporal lobe seizures
Where does the “figure of 4” or “fencing” posture lateralize to?
hemisphere contralateral to the extended arm
Where in the brain do somatosensory auras originate?
primary somatosensory area(unilateral) or supplementary sensorimotor (bilateral)
What are three features that are indicative of lateral temporal lobe onset rather than mesial temporal lobe onset?
Vertigo, clonic movements, or simple auditory
Animated and sometimes violent organized complex motor behaviors such as thrashing or kicking localize to the _____ Cortex
Orbital frontal cortex
Ictal spitting, vomiting, and coughing lateralize to which hemisphere?
right hemisphere
Unilateral dystonic limp posturing in temporal lobe seizures lateralizes to which hemisphere?
contralateral hemisphere
Where in the brain do simple auditory hallucinations such as ringing and buzzing originate?
-nondescript noise: Heschel’s gyrus.
-complex: temporal auditory association cortex
Olfactory symptoms such as unpleasant burning smell originate in what area of the brain?
medial temporal
Wherein the brain do gustatory sensations such as a bitter or bad taste originate?
Insula
Localization for myoclonic seizures (2)
Primary/premotor cortex
Localization for tonic seizures (3)
primary/premotor/supplementary motor cortex
Localization for clonic seizures (3)
primary/premotor/supplementary motor cortex
Localization for unilateral tonic-clonic seizures
-primary/premotor/supplementary motor cortex
-contralateral pre-motor and primary motor cortices
Version is seen when a seizure spreads to what area of the brain
Frontal eye fields
What is the duration of an epileptic spasm?
1-2 seconds
What is the most common manifestation of the supplementary sensorimotor area (SSMA) seizures
bilateral, asymmetric tonic posturing with preserved awareness, especially “fencer’s posture” also known asM2e
Unilateral ictal eye blinking lateralizes to which hemisphere?
ipsilateral hemisphere
A focal impaired awareness seizure with mirthless laughter (gelastic) or crying (dacrystic) is highly suggestive of_______
hypothalamic hamartoma
What is piloerection and where does it localize to?
errection of the hairs of the skin “goosebumps”. Strongly associated with temporal lobe epilepsies including the insula and amygdala.
Automatisms that typically involve the hands and mouth, such as lip smacking, chewing, and picking motions, tend to originate from which lobe of the brain?
Mesial temporal
Which of the following sets of features suggest onset in the frontoparietal operculum? A)chewing, swallowing, salivation B) clonic jerking of the lower extremities C) auditory hallucinations like buzzing
A) chewing, swallowing ,salivation
