140 extraordinarily deceptive manifestations of epilepsy

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!

By http://wellcomeimages.org/indexplus/image/L0005931.html, CC BY 4.0, Link

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 typesmyoclonic, atonic, tonic, and clonic – and these are all fairly descriptive of the abnormal electrical brain discharge that symbolises epilepsy.

http://wellcomeimages.org/indexplus/image/L0005933.html, CC BY 4.0, Link

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.

3D Brain Sculpture STL model. Misanthropic one on Flikr. https://www.flickr.com/photos/22902505@N05/14780918556

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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

Crying. Memekode on Flikr. https://www.flickr.com/photos/memekode/3741745674

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

Day 88-Scary movie. Dee Teal on Flikr. https://www.flickr.com/photos/deeleea/1279982002

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

Raised Fist. Bruckerrlb on Flickr https://www.flickr.com/photos/robbrucker/405268229

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

Anger. Madstreetz on Flickr. https://www.flickr.com/photos/11089605@N08/1551306241

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

Smile! Sean Jackson on Flikr. https://www.flickr.com/photos/sean-b/245744537

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

Arithmetic operations. Duncan C on Flickr. https://www.flickr.com/photos/duncan/2637871949

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

Manu Script. Kevin Walsh on Flickr https://www.flickr.com/photos/86624586@N00/10187684

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

Music is #SimplyIrresistible. Luca Florio on Flickr. https://www.flickr.com/photos/elle_florio/29516744480

Exiting water-induced

Reading-induced

Speech-induced

Strabismus

Altered taste

Bruxism

Phantom limb

Agraphia

Pelvic thrusting

Hyperventilation

Hypoventilation

Coughing

Apnoea

Pouting

Link

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

Whistling Boy. Mary Harrsch on Flickr. https://www.flickr.com/photos/mharrsch/294066770

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LINKS

Neurological manifestations of seizures

Systemic manifestations of seizures

Gelastic seizures

Dacrystic seizures

Reflex seizures

Transient epileptic amnesia (TEA)

Ecstatic seizures

Negative seizures

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Have we missed any? Please drop a hint!

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