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Title: Absence of an Autonomic Sign Assists in the Diagnosis of Extratemporal Lobe Epilepsy Manifesting Generalized Convulsion with Retained Awareness
Authors: Neshige, Shuichiro
Matsumoto, Riki
Inouchi, Morito
Kobayashi, Katsuya
Shimotake, Akihiro  kyouindb  KAKEN_id
Maruyama, Hirofumi
Takahashi, Ryosuke  kyouindb  KAKEN_id
Ikeda, Akio
Author's alias: 音成, 秀一郎
松本, 理器
井内, 盛遠
小林, 勝哉
下竹, 昭寛
高橋, 良輔
池田, 昭夫
Keywords: generalized
consciousness
autonomic symptoms
non-dominant hemisphere
insula
Issue Date: 15-Apr-2019
Publisher: Japanese Society of Internal Medicine
Journal title: Internal Medicine
Volume: 58
Issue: 8
Start page: 1151
End page: 1155
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.
Rights: The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/ by-nc-nd/4.0/).
URI: http://hdl.handle.net/2433/241268
DOI(Published Version): 10.2169/internalmedicine.1740-18
PubMed ID: 30568140
Appears in Collections:Journal Articles

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