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Year : 2021  |  Volume : 69  |  Issue : 4  |  Page : 1040--1042

Ictal Smile and Fear In A Child With Refractory Epilepsy - An Interesting Electro Clinical Correlation

1 Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
2 Department of Radiology, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
3 Department of Neurosurgery, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India

Correspondence Address:
Sita Jayalakshmi
Senior Consultant Neurologist, Krishna Institute of Medical Sciences, Minister Road, 1-8-31/1, Secunderabad - 500 003, Telangana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.325357

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Ictal fear is a common manifestation with seizures originating from temporal lobe, orbitofrontal region and cingulate cortex. Ictal smile has been described in association with seizures from hypothalamus, cingulate cortex, lateral and prefrontal cortex. Isolated fear or ictal smile has been reported in various published reports in the past in patients with cingulate epilepsy. We report an unusual semiology with ictal smiling along with fear and preserved sensorium during the event, in a four-year-old child; Our hypothesis was that the ictal origin, most likely from the right mesial frontal or cingulate cortex. The child underwent resective surgery after multimodality evaluation and has been seizure free for 6 years post-surgery.


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Online since 20th March '04
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