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CC BY-NC-ND 4.0 · International Journal of Epilepsy 2021; 07(02): 079-084
DOI: 10.1055/s-0041-1739400
Case Report

Descending Cephalic to Epigastric Sensation in a Patient with Mesial Temporal Lobe Epilepsy: A Novel Observation

Sachin Sureshbabu
1   Department of Neurology, Aster Malabar Institute of Medical Sciences Hospital, Kozhikode, Kerala, India
,
Merisin Joseph
1   Department of Neurology, Aster Malabar Institute of Medical Sciences Hospital, Kozhikode, Kerala, India
,
Sruthi K. G
1   Department of Neurology, Aster Malabar Institute of Medical Sciences Hospital, Kozhikode, Kerala, India
,
Smilu Mohanlal
1   Department of Neurology, Aster Malabar Institute of Medical Sciences Hospital, Kozhikode, Kerala, India
,
Sudhir Peter
2   Department of Pathology, Neuberg Diagnostics, Vishakhapatnam, Andhra Pradesh, India
,
Sobhana Chindripu
3   Department of Pathology, Guntur Medical College, Andhra Pradesh, India
,
Sujith Janardhanan
4   Department of Radiology and Imaging Science, Aster Malabar Institute of Medical Sciences Hospital, Kozhikode, Kerala, India
,
Sellam Karunanithi
5   Department of Nuclear Medicine, Aster Malabar Institute of Medical Sciences Hospital, Kozhikode, Kerala, India
,
Sreekumar T.K
6   Department of Neurosurgery, Aster Malabar Institute of Medical Sciences Hospital, Kozhikode, Kerala, India
,
Noufal Basheer
6   Department of Neurosurgery, Aster Malabar Institute of Medical Sciences Hospital, Kozhikode, Kerala, India
,
Jacob P. Alappat
6   Department of Neurosurgery, Aster Malabar Institute of Medical Sciences Hospital, Kozhikode, Kerala, India
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Abstract

One of the most frequent type of auras in mesial temporal lobe epilepsy (MTLE) is epigastric sensation. Until now the site of the symptomatogenic zone of the epigastric aura remains controversial. The temporal lobe as well as insular cortex has been implicated. Our case is that of a 29-year-old young woman patient who presented with an aura of descending cephalic to epigastric sensation as opposed to the prototypical ascending aura. Interictal and ictal recording favored a mesial temporal pattern. Magnetic resonance imaging brain showed left mesial temporal lobe sclerosis. Interictal positron emission tomography showed concordant findings. The patient underwent selective amygdalohippocampectomy following which she remains seizure-free. This previously unreported clinical expression of MTLE and its origins is discussed.

Keywords

epilepsy - epigastric aura - mesial temporal lobe epilepsy


Publication History

Article published online:
06 January 2022

© 2022. Indian Epilepsy Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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