Monday, April 26, 2010

Where's the Lesion?

A 20 year old presents with a seizure. He says he felt a rising roller-coaster sensation in his stomach, a feeling of deja vu along with intense fear, and a weird smell. Then his roommate noticed he had a behavioral arrest with staring that lasted 30-120 seconds. The patient was unaware and unresponsive during this time, but he did have stereotyped purposeless fidgeting of his hands. At this time, the roommate called 911. The patient does not remember anything.

Challenge: If you were to guess where the lesion is, what would you say?


Suheil said...

Frontal Lobe.. Complex Partial Seizure..

Craig Chen said...

yep it's a complex partial sz...was going for temporal lobe
Where's the Lesion?

This is temporal lobe epilepsy, most commonly in the mesial temporal lobe (hippocampus, amygdala, and parahippocampal gyrus), usually caused by mesiotemporal (hippocampal) sclerosis. Complex partial seizures, seizure aura (including rising epigastric sensation, psychic phenomena, and auras of taste and smell), and automatisms.

Source: UpToDate.