Abstracts

Piloerection is rarely described in seizures. In the few reported cases, it has been suggested it involves the connections between the temporal lobe and the hypothalamus or the preoptic areas. We describe the first case of a patient who experienced pilomotor seizures for several weeks in relation to a transient MRI signal abnormality. A 35-year-old right-handed woman exhibited sudden epilepsy with a seizure frequency reaching 30 per day. They lasted less than 90 seconds each. They consisted of bilateral sensation of chill associated with nausea, thoracic sensation, and followed few seconds later by piloerection involving both arms and legs. EEG recording found slow waves on the left temporal region. MRI performed one week after the first seizure, showed a T2 and FLAIR signal increase in the left mesial temporal area without mass effect. She received antiepileptic drugs which decreased the severity and the frequency of seizures. Four months later, MRI showed a clear regression of the signal abnormality. At this time the number of seizures decreased from 30 to 10 per day. EEG-video performed at this time, recorded 6 seizures, each lasting less than 1 minute. These seizures consisted of sensation of chill ascending from the feet to all of the body associated with piloerection in the left arm. Ictal EEG found a rythmic slow activity with a maximum amplitude on the left central and temporal area. Our observation showed that piloerection could be the main feature in the course of partial seizure of temporal lobe origin. The transient MRI T2 and FLAIR signal abnormality might be in relation with the high seizure frequency. Piloerection is probably more frequent than suggested in the course of temporal lobe seizures.