Numbers
- Infrequent in both medical and surgical cases
- Representing from 4.4% to 6% of all epilepsies.
Etiology
- Strong association with SOL (tumors, congenital anomalies, postinflammatory brain scarring, and vascular lesions)
Clinical features
Somatosensory symptomatology at onset
- All sensory modalities may be experienced, and often more than one type is perceived in each seizure.
- The two most common manifestations include
- Paresthetic seizures
- Most common somatosensory perception in seizures.
- Reported as tingling and/or numbness.
- Other descriptions
- Pins and needles, prickling, or a crawling under the skin.
- Sensation usually starts in a segment of the limb, usually distal, and then spreads to involve the whole extremity in a march-like fashion.
- Painful seizures
- Experienced in conjunction with other sensory perceptions.
- Described as severe, stabbing, throbbing, or cramp-like.
- The hands are most commonly involved, especially distal, followed by the head, face, and legs.
- Less frequent somatosensory seizures of parietal lobe origin include
- Thermal perception,
- Sexual seizures,
- Ideomotor apraxia,
- Disturbances of body image.
Spread
- Frontal lobe
- Tonic posturing, clonic activity, contralateral version, and hypermotor activity
- Temporal lobes
- Automatism and alteration of consciousness.
- Occipital lobes
- Visual auras.
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