Moments of the self

A study just published in the Journal of Forensic Sciences gives a wonderful example of the little recognised complexity of epileptic seizures.

The article describes three cases of people who take their clothes off during seizures and discusses the potential legal consequences of engaging in such behaviour when it was caused by epilepsy.

However ‘Case 1’ has so many other aspects to it, it really highlights the diversity of epilepsy. It can cause, for example, the sensation of “needing to look for something”.

Case #1 involves a women in her mid-30s with seizures that begin with an aura of “needing to look for something” followed by prominent sensations of heat. The patient often fans herself during seizures. During a clinic visit, she was observed to have a complex partial seizure during which she reached into her blouse and pulled out her bra. In the epilepsy monitoring unit (EMU), she had two complex partial seizures, one of which involved disrobing behavior. The seizure began with her sitting in bed talking to her husband in a normal fashion. She then became unusually restless.

Ten seconds after the onset of 4-Hz right temporal activity, chewing movements began. Thirty-two seconds after the onset, she began fanning herself with her right hand. Two minutes ten seconds after the onset, the electrical activity stopped for 8 sec. It then resumed at 8 Hz in the right temporal electrodes; after another 5 sec, she unbuttoned her pajama top with both hands. Bilateral rhythm ictal electrode activity continued to gradually increase in amplitude. Fifty-five seconds after the unbuttoning, she picked up a newspaper in her right hand and fanned herself for 10 sec. The seizure then evolved into a secondary generalized tonic/clonic seizure.


Link to locked study.

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