A 68-year-old man complained of acute and recurrent episodes of diffuse gooseflesh variably accompanied by nonfluent aphasia, emotional distress, and focal myoclonic jerks (video 1 on the Neurology ® Web site at www.neurology.org), lasting about 2 minutes and occurring up to every 15 minutes. Contemporaneous EEG recording showed epileptic discharges over left temporal derivations (video 2). MRI showed a left temporal mass extending from the temporal pole to the pulvinar and involving amygdala and hippocampus (figure). Seizures were managed with valproate and levetiracetam. Partial lobectomy was performed demonstrating a grade III anaplastic astrocytoma. Pilomotor seizure 1,2 is a rare subtype of autonomic epilepsy related to temporal lesion of which it may be the presenting symptom, usually associated with other manifestations of temporal lobe epilepsy.L. Fisch, MD,* P. Mégevand, MD,* A. Badoud, PhD, M. Seeck, MD, P.R. Burkhard, MD, Geneva, Switzerland *These authors contributed equally to this work.Author contributions: Dr. Fisch: drafting and editing of the manuscript, acquisition, analysis, and interpretation of data. Dr. Mégevand: drafting and editing of the manuscript, acquisition, analysis, and interpretation of data. S. Badoud: drafting the manuscript, acquisition, analysis, and interpretation of data. Prof. Seeck: revision of the manuscript, acquisition, analysis, and interpretation of data. Prof. Burkhard: revision of the manuscript, acquisition, analysis and interpretation of data, study supervision and coordination.
