Semiology of the rare seizure subtype piloerection

Erek M. Lam, Gregory Alan Worrell, Ruple S. Laughlin

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: To report piloerection and vasomotor instability as a sole manifestation of partial seizures. Design: Case report. Setting: Inpatient tertiary care center. Patient: A 72-year-old man with acute onset of repetitive autonomic events. Main Outcome Measures: Extensive cardiovascular evaluation, electroencephalographic testing, radiology, laboratory assessment, and frequency of clinical events (seizures). Results: We characterize an uncommon manifestation of right temporal lobe partial seizures, initially thought to be cardiovascular in origin, as pilomotor seizures accompanied by other autonomic phenomena. The ictal electroencephalogram recordings established the diagnosis of right temporal lobe seizures, and head magnetic resonance imaging demonstrated right mesial temporal T2 signal change, enhancement, and subsequent atrophy. The underlying etiology was not uncovered despite an extensive laboratory and radiological evaluation. However, given the history and imaging findings, an infectious or secondary immunological etiology was suspected. Conclusions: Pilomotor events with other transient autonomic features, such as tachycardia and blood pressure fluctuations, may represent localization-related epilepsy. The acute onset of these events accompanied by other autonomic phenomena in the setting of focal magnetic resonance imaging abnormalities within the hippocampal region raises questions concerning pilomotor seizures as well as the differential diagnosis of acute seizure activity in the setting of neuroimaging findings characteristic for limbic encephalitis.

Original languageEnglish (US)
Pages (from-to)1524-1527
Number of pages4
JournalArchives of Neurology
Volume67
Issue number12
DOIs
StatePublished - Dec 2010

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Piloerection
Seizures
Temporal Lobe
Limbic Encephalitis
Magnetic Resonance Imaging
Partial Epilepsy
Semiology
Radiology
Tertiary Care Centers
Tachycardia
Neuroimaging
Atrophy
Inpatients
Electroencephalography
Differential Diagnosis
History
Stroke
Head
Outcome Assessment (Health Care)
Blood Pressure

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Semiology of the rare seizure subtype piloerection. / Lam, Erek M.; Worrell, Gregory Alan; Laughlin, Ruple S.

In: Archives of Neurology, Vol. 67, No. 12, 12.2010, p. 1524-1527.

Research output: Contribution to journalArticle

Lam, Erek M. ; Worrell, Gregory Alan ; Laughlin, Ruple S. / Semiology of the rare seizure subtype piloerection. In: Archives of Neurology. 2010 ; Vol. 67, No. 12. pp. 1524-1527.
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