Ictal Tonic Postural Changes and Automatisms of the Upper Limb During Epileptic Parietal Lobe Discharges

Abstract

Tonic postural changes of the upper limb accompanied by epileptic parietal lobe discharges are not well known. Three such cases were reported. In the 3 patients a total of 18 spontaneous seizures were recorded, 12 by telemetry, from either scalp electrodes or stereotactically implanted electrodes. Of these 18 seizures, 14 included tonic postural changes of the upper limb accompanied by a contralateral parietal discharge. Combining these 3 cases with 4 such cases in the literature, the clinical pattern consisted of a tonic postural change in 1 upper limb associated with automatisms of the opposite upper limb. The same patient might have automatisms involving the upper limb in some seizures and upper limb postural changes in other seizures, both accompanied by the same electrical discharge. Tonic postural changes and automatisms in the upper limb may be interchangeable.