HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by van der Sluijs, B M Articles by Bloem, B R Search for Related Content PubMed PubMed Citation Articles by van der Sluijs, B M Articles by Bloem, B R Related Collections Other Neurology Epilepsy

Diagnosis at the tip of the tongue

Department of Neurology, Radboud University Nijmegen Medical Centre, The Netherlands

Correspondence to:
Correspondence to:
Dr B M van der Sluijs
Department of Neurology (935), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands; b.vandersluijs@neuro.umcn.nl

Received 25 November 2005
In final revised form 25 November 2005

Accepted for publication 1 December 2005

Keywords: tongue bite; epilepsy; seizures; syncope

The first 150 words of the full text of this article appear below.

A 21 year old woman presented with three episodes of transient loss of consciousness and generalised clonic limb jerking. Post-ictal neurological examination was normal, but there was a tongue bite with laceration on the lateral side, highly suggestive for epilepsy. Magnetic resonance imaging of the brain (performed in the diagnostic investigation for seizures) also demonstrated the classical lateral tongue bite.

Transient loss of consciousness accompanied by limb jerking can occur both in generalised epileptic seizures and in syncope.¹ Urinary incontinence is not a helpful distinguishing feature, as this occurs in 17% of generalised seizures and in 26% of syncopal events.^2,3 The presence of tongue bite strongly suggests epilepsy (occurs in up to 41% of generalised tonic clonic seizures), although it may occasionally occur in syncope (2–6%). The site of the laceration should be noted, as it is typically lateral in epilepsy, but at the tip of the tongue in syncope.³

View larger version (117K): [in this window] [in a new window]   Figure 1 . . . [Full text of this article]