Agnetti, Virgilio and Nuvoli, Susanna Maria Francesca and Murrighile, M. Raffaela and Marongiu, Giommaria and Todesco, Silvano and Ortu, Renato (2005) Left hemisphere dominance for pilomotor seizures: clinical and SPECT clues without EEG signs. Journal of Neurology, Vol. 252 (Suppl. 2), p. 56-57. eISSN 1432-1459. Article.
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Cold shiver and piloerection with bilateral symmetrical onset are rare symptoms of epileptic seizures. Attempts to explore their localising and lateralising value suggested the temporal lobe as the ictal onset zone in many cases,whereas a l-hemisphere dominance in patients with bilateral ictal piloerection remains controversial. With the support of video-EEG sequences we present a case showing that involvement of axial structures together with symmetrical cold shiver and horripilation complicate the interpretation in absence of specific electrical abnormalities. The clinical observation and 99mTc-HMPAO SPECT were clues for a left localisation of the epileptic focus.
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