Epilepsy is a very common neurological disorder, and many people feel confident they can recognise an epileptic seizure when they see one. In the popular imagination, epilepsy consists of falling to the ground, shaking all the limbs vigorously, foaming at the mouth, biting the tongue, and wetting the pants. This is of course an accurate depiction of the iconic generalised tonic-clonic seizure – more graphically epitomised by its old name, grand mal!
A less dramatic but relatively familiar expression of epilepsy is the absence seizure – again better depicted by its defunct name of petit mal. This consists of a brief vacant or staring spell which may occasionally be associated with minor eyelid, lip, or hand movements. The International League Against Epilepsy (ILAE) also lists the following classical epilepsy types – myoclonic, atonic, tonic, and clonic – and these are all fairly descriptive of the abnormal electrical brain discharge that symbolises epilepsy.
Many people with epilepsy however do not have these classical symptoms of epilepsy. Indeed many will manifest with what are simply bizarre and peculiar features. These, rather than the conventional grand mal or petit mal, are what keep neurologists awake at night. To ferret out the most unusual presentations of what is arguably the most clandestine neurological disorder, I scoured Neurochecklists and unearthed these 140 extraordinarily deceptive manifestations of epilepsy. Peruse and then follow the links at the end.
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Swearing
Hushing
Verbal help-seeking
Religious speech
Barking
Aphasia
Dysphasia
Coproplalia (foul speech)
Pedalling
Gyrations
Signum crucis: sign of the cross
Running
Dancing
Crying
Undressing
Fencer’s posture
Incoordination
Lip smacking
Unilateral eye blinking
Unilateral droopy eyelid (ptosis)
Miosis (small pupils)
Lacrimation (tearing)
Nose wiping
Smiling
Spitting
Kissing
Drinking
Fear
Singing
Humming
Laughing
Forced head turning
Body turning
Turning prone
Dystonic posturing
Hemiballic movements
Déjà vu
Jamais vu
Blindness
Homonymous hemianopia
Hot-cold sensations
Making a fist
Pointing
Cupping the fingers
Pincer movement
Extending the hand
Hand waving
Finger snapping
Dorsiflexion of the toes
Screaming
Forced thinking
Hallucinations
Illusions
Anger
Aggression
Rage
Panic attacks
Catastrophic depression
Depersonalisation
Derealisation
Delusion of sexual transformation
Inability to perceive motion (akinetopsia)
Perception of multiple images (polyopsia)
Attraction to television (telephilic syndrome)
Hot water-induced
Touch-induced
Tap-induced
Pattern-induced
Ecstasy
Happiness
Deafness
Auditory perseveration
Chest pain (epileptic angina)
Abdominal pain
Neck pain
Limb pain
Nasal pain
Headache
Analgesia
Drawing-induced
Chess-induced
Toothbrush thinking-induced
Problem solving-induced
Arithmetic-induced
Amnesia
Palpitations
Pain behaviour without pain
Nausea
Vomiting
Piloerection
Flushing
Startle-induced
Tooth brushing-induced
Cutaneous stimulation-induced
Eating or chewing-induced
Mahjong-induced
Smell-induced
Writing-induced
Apraxia
Catastrophic depression
Homonymous hemianopia
Negative myoclonus
Neglect
Urinary urgency
Erection
Orgasm
Urge to defecate
Orgasm-induced
Micturition-induced
Menstruation-induced
Startle induced
Music-induced
Exiting water-induced
Reading-induced
Speech-induced
Strabismus
Altered taste
Bruxism
Phantom limb
Agraphia
Pelvic thrusting
Hyperventilation
Hypoventilation
Coughing
Apnoea
Pouting
Rhythmic tongue movements
Bed leaving
Impulsivity
Yawning
Prosopagnosia (inability to recognise faces)
Jargon speech
Head nodding
Drop attacks
Fainting
Numbness
Eructation (belching)
Isolated enuresis (bedwetting)
Flatulence
Whistling
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LINKS
Neurological manifestations of seizures
Systemic manifestations of seizures
Transient epileptic amnesia (TEA)
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To explore these and many other comprehensive neurology checklists…
Go online at Neurochecklists.com
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