Fourteen patients with ictal piloerection
| Age, sex, handedness | Related condition | Seizure semiology (frequency) | Awareness of pilo | Distribution of pilo | EEG | Imaging findings | Surgery, outcome |
|---|---|---|---|---|---|---|---|
| →, evolves into; A, atrophy; abd, abdominal; AVM, arteriovenous malformation; bil, bilateral; CNS, central nervouse system; d, day; DD, developmental delay; EEG, electroencephalogram; F, female; GAD, gadolineum; GTC, generalised tonic-clonic seizure; gust, gustatory; H, hippocampal; HV, hyperventilation; IRS, intermittent rhythmic slow; L, left; LOC, loss of consciousness; M, male; MCD, malformation of cortical development; mo, months; MRI, magnetic resonance imaging; olfact, olfactory; R, right; SOB, shortness of breath; T, temporal; O, occipital; P, parietal; PET, positron emission tomography; pilo, piloerection; S/p, status post; SPECT, single photon emission computed tomography; TS, tuberous sclerosis; yr, year. | |||||||
| 36, M, R | None | Olfact/gust aura →automotor (LOC) →pallor/diaphoresis, L pilo (1/d) | No | L body, ipsilateral | Interictal: LT 90%, RT 10% | MRI: normal | – |
| Ictal: LT | |||||||
| 41, M, R | Head trauma | HV/pilo/diaphoresis (→arm and leg tingling) (→GTC) (3/d) | Yes | Bilateral | Interictal: IRS LT | MRI: normal | – |
| Ictal: LT | |||||||
| 51, M, R | None | Cold, pilo →nausea, SOB, loneliness, distress, tachycardia (1–2/d) | Yes | Bilateral | Interictal: RT | MRI: R HA | – |
| Ictal: RT | |||||||
| 15, F, R | TS, mild DD | Cold, pilo, nausea →LOC, automatisms (→GTC) (1–2/d) | Yes | Bilateral | Interictal: RT | MRI: R HA and multiple tubers | RT, seizures returned 2 mo after surgery (1/mo) |
| Ictal: RT | PET: RT hypometabolism | ||||||
| Ictal SPECT: R anterior T hyperperfusion | |||||||
| S/p RT lobectomy | After surgery: pilo/cold (1/mo) | Yes | Bilateral | Ictal: R FP | MRI: S/p RT lobectomy, multiple bil hamartomas | ||
| Interictal: LT 75%, RTP 25% | |||||||
| 27, M, R | None | L arm pilo, cold, diaphoresis, SOB→automatisms (LOC) →GTC (2/week) | Yes | Initial L body, ipsilateral | Interictal: LT 65%, RT 35% | MRI: cavernous angioma L superior T gyrus | L superior T, with intraoperative language mapping, seizure free |
| Ictal: LT | PET: LT hypometabolism | ||||||
| 21, M, R | None | Hyperventilation, gust aura, hypersalivation, pilo→LOC, automatisms, hyperlacrimation (→GTC) (3/week) | No | Bilateral | Interictal: LT | MRI: L T MCD | LT, rare auras returned after 6 mo (hand tingling and gust, 4/y) |
| Ictal: L T | PET: L>RT hypometabolism | ||||||
| 57, M, R | None | Paresthesias in the nose, light-headed, bilateral arm and leg pilo (2/week) | Yes | Bilateral | Interictal: none | MRI: R HA | – |
| Ictal: R T | |||||||
| 24, F, R | Head trauma age 8 mo | Two seizure types were recorded: | Interictal: RT 95%, LT 5% | MRI: L HA | – | ||
| 1. warning (strange feeling), perioral paresthesias, staring, LOC, automatisms (3/week) | Bilateral | 1. Ictal: LT | |||||
| 2. staring, LOC, pilo R postictally (1/week) | No | R body, ipsilateral | 2. Ictal: RT | ||||
| 53, M, R | Head trauma age 36 | Abd aura, pilo both arms (GTC) (5–6/d) | Yes | Bilateral | Interictal: RT | MRI: R HA | – |
| Ictal: RT | |||||||
| 21, M, R | Meningitis age 1 month, febrile convulsions age 1 mo | Pilo L leg, then bil, cephalic sensation, staring, LOC, hand automatisms, R arm stiffening, occasional postictal aphasia (1/d) | Yes | Initial L body, ipsilateral | Interictal: LT | MRI: L HA and L FP encephalomalacia | LT, seizure free |
| Ictal: LT, confirmed by invasive recordings | PET: LT hypometabolism | ||||||
| 45, M, R | Head trauma in childhood | Abd and olf aura, light-headed, difficulties understanding, bil pilo (15/d) | No | Bilateral | Interictal: LT | MRI: LH enlargement, enhancement of LH head after gad | LT, seizure-free |
| Ictal: LT | Path: CNS-vasculitis | ||||||
| 49, M, R | None | Cephalic sensation, anxiety, tachycardia, pilo (1–2/d) | No | Bilateral | Interictal: RT | MRI: normal | – |
| Ictal: RT | |||||||
| 53, F, R | Low grade glioma | Urinary urge, fear, tachycardia, HV, abd aura, bil pilo, chills, L face tonic, GTC (1/mo) | Yes | Bilateral | R TP | MRI: R FT low-grade glioma | LT, lost to follow up |
| PET: R hemispheric hypometabolism | |||||||
| 54, F, R | AVM rupture | HV, chills, fear, tachycardia, shaking, L arm pilo, then bil, urinary urge, automatisms, no LOC (3–4/mo) | Yes | Initial L body, contralateral | Interictal: RT 90%, RTP 10% | MRI: R superior T encephalomalacia after AVM rupture | RT, follow up pending |
| Ictal: RT, confirmed by invasive recordings | |||||||