Bicycling Movements as a Manifestation of Complex Partial Seizures of Temporal Lobe Origin

Sussman, Neil M.; Jackel, Roy; Kaplan, Linda R.; Harner, Richard N.

doi:10.1111/j.1528-1157.1989.tb05467.x

Cited by 22 publications

(7 citation statements)

References 6 publications

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“…Three preliminary reports have described similar behaviors occurring in the context of temporal lobe seizures. In one case, Sussman et al (1989) noted such behaviors after bilateral spread of discharges from a temporal lobe origin. In two other studies similar automatisms were noted in the course of temporal lobe seizures (Sussman e t al., 1989;.…”

Section: Discussionmentioning

confidence: 98%

“…Other investigators have described orbitofrontal or deep mesiofrontal seizures without BBAs (Penfield and Kristiansen, 1951;Bancaud et al, 1965, Niedermeyer andWalker, 1971). Of the three reports suggesting that these automatisms could appear in the course of temporal lobe seizures (Sussman et al, 1989;Park et al, 1990;, only the last two preliminary reports correlated location of discharges at time of occurrence of the automatisms in question, suggesting that bilateral spread had occurred at the time these BBAs appeared.…”

Section: Discussionmentioning

confidence: 99%

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Electrophysiology of Bimanual‐Bipedal Automatisms

Swartz

1994

Epilepsia

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To determine the localizing value and electrophysiology of bimanual-bipedal automatisms (BBAs), we studied these behaviors in 54 seizures of 8 patients with temporal or frontal lobe seizure onset. BBAs occurred with a frequency of 27% in frontal lobe epilepsy (FLE) and of 7% in temporal lobe epilepsy (TLE). The distribution of electrode sites showing ictal activity during these automatisms was significantly different in the two patient groups (0.0001 Chi-square). Mesio- and/or laterotemporal plus orbital frontal areas were involved areas when the behaviors appeared in patients with TLE; dorsolateral and mesiofrontal regions were the most commonly involved when the behaviors occurred during the course of frontal lobe seizures. We concluded that BBAs represent activation of frontal lobe circuitry but are not unique to seizures of frontal lobe origin. Eyelid flutter and repetitive body movements in either the axial or sagittal plane were significantly associated with the frontal lobe group whereas oral-alimentary automatisms were associated with the temporal lobe group. Thus, these associated behaviors may help indicate whether a frontal or temporal lobe seizure onset has occurred when BBAs are observed. A new concept of ictal expression is proposed to conform with the results as well as with other apparently disparate ictal behaviors that may have localizing value.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Electrophysiology of Bimanual‐Bipedal Automatisms

Swartz

1994

Epilepsia

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“…For example, bicycling leg movements have also been reported in seizures originating from the temporal lobe. 55…”

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confidence: 99%

Psychogenic (Nonepileptic) Seizures

Krumholz

Hopp

2006

Semin Neurol

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Psychogenic (nonepileptic) seizures are among the most common and serious of all psychogenic neurological disorders. They account for approximately 20% of all intractable seizure disorders referred to comprehensive epilepsy centers and present with a reported annual incidence of approximately 4% that of true epilepsy. These events are serious and disabling. Indeed, compared with patients with true epilepsy, patients with psychogenic seizures exhibit more frequent, severe, and disabling seizures as well as a poorer quality of life. The diagnosis and management of psychogenic seizures remain challenging, although advances in video electroencephalographic (EEG) monitoring have improved the ability of physicians to identify these disorders accurately. The prognosis of these patients is still relatively poor, and a good outcome seems dependent on a young age at diagnosis, early diagnosis, less severe psychological comorbidities, and continued follow-up and management by the diagnosing neurologist or clinician. Additional psychological or psychiatric assessment may be beneficial, particularly in elucidating the etiology of the disorder as well as identifying comorbid disorders, and may help in the long-term management of these patients. This review presents the history, epidemiology, differential diagnosis, and management of psychogenic seizures, with particular attention to the use of diagnostic testing, including video EEG monitoring.

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“…In particular, seizures arising from the frontal lobes proved to break most of the established assumptions. Hypermotor seizures (as they are termed by Azar et al in this report) associated with frontal lobe epilepsy commonly display all of the behaviors thought to be virtually diagnostic of pseudoseizures, while EEG/video of pseudoseizures has revealed that urination, injury, and drug responsiveness may be part of many nonepileptic episodes (2,3). As a result, EEG/video has become the gold standard for discriminating between epileptic and nonepileptic attacks.…”

Section: Commentarymentioning

confidence: 73%

Diagnosing Pseudoseizures: Don't Hold Your Breath

Bergen¹

2008

Epilepsy Curr

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Chronic treatment with antiepileptic medication is associated with reduced bone mineral density (BMD), which may underlie the twoto sixfold increase in fracture rates observed in patients with epilepsy. The objective was to determine the timing of the BMD deficit in ambulatory children with epilepsy. METHODS: A cross-sectional evaluation was conducted in 82 ambulatory children aged 6 to 18 years (12.4 ± 3.3 years) with epilepsy for <1 year (n = 18), 1 to 5 years (n = 37), and 6 or more years (n = 27). Controls were 32 healthy children aged 12.8 ± 2.6 years. Age-and sex-corrected total body BMD Z-score was measured. RESULTS: Total BMD Z-score was lower in children with epilepsy (0.10 ± 0.96; CI = −0.08, 0.34) compared to controls (0.57 ± 0.74; CI = 0.3, 0.84; p = 0.03).

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Bicycling Movements as a Manifestation of Complex Partial Seizures of Temporal Lobe Origin

Cited by 22 publications

References 6 publications

Electrophysiology of Bimanual‐Bipedal Automatisms

Electrophysiology of Bimanual‐Bipedal Automatisms

Psychogenic (Nonepileptic) Seizures

Diagnosing Pseudoseizures: Don't Hold Your Breath

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