Anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis is a treatable form of limbic encephalitis, marked by frequent focal seizures and cognitive decline (particularly memory disturbance); however, it can be difficult to diagnose in patients with subtle cognitive decline. Ictal pouting, a rare seizure feature, has not yet been reported in anti-LGI1 encephalitis. A 73-year-old man with anti-LGI1 encephalitis presented with subacute onset of frequent ictal pouting without apparent cognitive decline. Steroid treatment alone resolved seizures and improved subtle visual memory. Middle-aged and older patients experiencing subacute-onset frequent focal seizures should be thoroughly evaluated for memory disturbances to determine the need for anti-LGI1 antibody measurement.
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http://dx.doi.org/10.2169/internalmedicine.4025-24 | DOI Listing |
Intern Med
September 2024
Department of Neurology, Kobe City Medical Center General Hospital, Japan.
Anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis is a treatable form of limbic encephalitis, marked by frequent focal seizures and cognitive decline (particularly memory disturbance); however, it can be difficult to diagnose in patients with subtle cognitive decline. Ictal pouting, a rare seizure feature, has not yet been reported in anti-LGI1 encephalitis. A 73-year-old man with anti-LGI1 encephalitis presented with subacute onset of frequent ictal pouting without apparent cognitive decline.
View Article and Find Full Text PDFJ Clin Neurophysiol
September 2023
Neurology, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, QC, Canada; and.
In this review, the semiology, and characteristics of noninvasive investigations suggestive of anterior cingulate and anterior midcingulate epilepsy are detailed by the authors. The clinical presentation is representative of a recently recognized rostrocaudal gradient of functional connectivity with seizures of the anterior cingulate cortex manifesting emotional and interoceptive aura followed by a hyperkinetic or complex motor seizures. The few reports of anterior midcingulate epilepsy show a trend toward a higher proportion of sensory auras and premotor semiology.
View Article and Find Full Text PDFNeurology
April 2023
From the Adult Genetics Epilepsy Program (P.M., D.M.A.), Toronto Western Hospital, ON, Canada; Division of Neurology (P.M., R.W., D.M.A.), Department of Medicine, University of Toronto, ON, Canada; and Krembil Brain Institute (R.W., D.M.A.), University Health Network, Toronto Western Hospital, ON, Canada.
Epileptic Disord
October 2022
Epilepsy Monitoring Unit, Emergency University Hospital Bucharest, Romania
Objectives: Parietal lobe epilepsy is one of the rarest types and patients with this form of epilepsy report multiple subjective symptoms during ictal manifestation. Specific facial coupling of emotion and motor symptoms may take various forms, such as pouting and disgust or smiling. We aimed to highlight brain structures and the network involved during ictal grimacing in parietal lobe seizures.
View Article and Find Full Text PDFEpileptic Disord
April 2021
Department of Neuropediatrics, University Children's Hospital Zurich, Switzerland.
The chapeau de gendarme sign or ictal pouting has been associated with focal epilepsy of frontal origin. The identification and characterization of this semiologic feature derive mainly from adult epilepsy surgery series, whereas paediatric cases have rarely been reported. Here, we present a 14-month-old girl with a chapeau de gendarme sign with eyes closed as the sole initial manifestation of left frontal lobe epilepsy.
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