Seizure semiology and localization: not everything is generalized onset tonic-clonic. 🧠⛈️
Part 4: postictal features🗣️
Last one, finally.
🤔
#Neurology #neurotwitter #Teaching #Education #EndNeurophobia
1/🧵
Part 4: postictal features🗣️
Last one, finally.
🤔
#Neurology #neurotwitter #Teaching #Education #EndNeurophobia
1/🧵
🚨
This tweetorial is based on:
Epilepsy Behav. 2005 Aug;7(1):1-17.
doi: 10.1016/j.yebeh.2005.04.004
This paper was written using the previous classification system and some data may need an update, nevertheless I find it useful when teaching about seizure semiology. 📓
2/🧵
This tweetorial is based on:
Epilepsy Behav. 2005 Aug;7(1):1-17.
doi: 10.1016/j.yebeh.2005.04.004
This paper was written using the previous classification system and some data may need an update, nevertheless I find it useful when teaching about seizure semiology. 📓
2/🧵
1⃣ Todd's palsy
Sx: postictal paresis.
Where? Contralateral primary motor areas.
3/🧵
Sx: postictal paresis.
Where? Contralateral primary motor areas.
3/🧵
2⃣ Aphasia and dysphasia
Sx: aphasia. 🔇
Where? Language dominant hemisphere. 🗣️📢
4/🧵
Sx: aphasia. 🔇
Where? Language dominant hemisphere. 🗣️📢
4/🧵
3⃣ Nosewiping
Sx: nosewiping. 👃🥸
Where? Temporal lobe, ipsilateral.
5/🧵
Sx: nosewiping. 👃🥸
Where? Temporal lobe, ipsilateral.
5/🧵
4⃣ Disorientation
Sx: prolonged spatial disorientation. 🚗⛰️
Where? Right hemisphere. ▶️
6/🧵
Sx: prolonged spatial disorientation. 🚗⛰️
Where? Right hemisphere. ▶️
6/🧵
5⃣ Flattened affect
Sx: Flattened or depressed affect. 🫠
Where? Right hemisphere.
6/🧵
Sx: Flattened or depressed affect. 🫠
Where? Right hemisphere.
6/🧵
6⃣ Ipsilateral tongue biting
Sx: Tongue biting in one side. 👅
Where? Ipsilateral to the bitten side. 😛
7/🧵
Sx: Tongue biting in one side. 👅
Where? Ipsilateral to the bitten side. 😛
7/🧵
7⃣ Peri-ictal water drinking
Sx: Water drinking during a seizure. 🌊
Where? Nondominant temporal lobe. 🥤
8/🧵
Sx: Water drinking during a seizure. 🌊
Where? Nondominant temporal lobe. 🥤
8/🧵
8⃣ Memory impairment.
Sx: Memory impairment after a seizure. 📝
Where? Left temporal lobe. 🧠
9/🧵
Sx: Memory impairment after a seizure. 📝
Where? Left temporal lobe. 🧠
9/🧵
Final words
1⃣ These signs in seizure semiology are an important
facet in the complete presurgical evaluation.
2⃣ Seizure semiology constitute an important segment, but should never be the sole source of information as lateralizing signs may be occasionally misleading.
10/🧵
1⃣ These signs in seizure semiology are an important
facet in the complete presurgical evaluation.
2⃣ Seizure semiology constitute an important segment, but should never be the sole source of information as lateralizing signs may be occasionally misleading.
10/🧵
Final words 2
3⃣ The list of lateralizing features increases steadily.
4⃣ Lateralizing clinical features may not be limited to focal epilepsy and may also be seen in patients with generalized epilepsy.
11/🧵
3⃣ The list of lateralizing features increases steadily.
4⃣ Lateralizing clinical features may not be limited to focal epilepsy and may also be seen in patients with generalized epilepsy.
11/🧵
Final words 3
5⃣ Recognition of the presence or absence of a lateralizing sign may be highly dependent on the level of training of the observer.
12/🧵
5⃣ Recognition of the presence or absence of a lateralizing sign may be highly dependent on the level of training of the observer.
12/🧵
This whole tweetorial (including the final words) is based on Epilepsy Behav. 2005 Aug;7(1):1-17.
doi: 10.1016/j.yebeh.2005.04.004.
Thanks and hope you have enjoyed and learned something.
🧠⛈️
13/13
doi: 10.1016/j.yebeh.2005.04.004.
Thanks and hope you have enjoyed and learned something.
🧠⛈️
13/13
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