We investigated, by means of video-polygraphic recordings of different seizure types, incidence and semiological characteristics of ictal "perioral grimace" (PG), defined as forced lowering of the mouth and elevation/protrusion of the inferior lip, often associated with abduction of the arms and enfolding of the head. We selected seizure groups suggesting involvement of (1) Frontal regions, presenting with falling (10 patients), tonic (6 patients) or hyperkinetic (12 patients) seizures, (2) Temporal regions, manifesting seizures with gestural and oro-alimentary automatisms and (3) Parieto-Occipital areas, having seizures with sensory semiology (15 patients). The pattern of muscular activation during PG was evaluated with FACS (Face Activation Coding System) and polygraphic recordings. PG resulted an early manifestation, observed in frontal lobe seizures group; it was present in 100% of falling seizures and tonic seizures during sleep, appearing at seizure onset and lasting for the whole ictal duration, and in 87% of hyperkinetic seizures, with a mean latency of 2 seconds, duration of 11 seconds and recurrence of 1-5 events per seizure. FACS and EMG studies documented a homogeneous pattern of muscular activation during PG. In conclusion, PG is an early ictal manifestation that can precede different motor patterns (tonic, falling, hyperkinetic seizures), as an "entrance" for seizures with "frontal" semiology.
|Translated title of the contribution||Clinical-EEG-polygraphic study of perioral grimace: An early manifestation of frontal lobe seizures|
|Number of pages||3|
|Journal||Bollettino - Lega Italiana contro l'Epilessia|
|Publication status||Published - Jul 2003|
ASJC Scopus subject areas
- Clinical Neurology