Ictal Fear during parietal seizures

Area of Science:

• Neuroscience
• Epileptology
• Clinical Neurology

Background:

• Ictal fear, a rare seizure manifestation, is typically associated with temporal lobe epilepsy.
• Parietal lobe seizures rarely present with prominent fear semiology.
• Understanding the neuroanatomical underpinnings of ictal fear is crucial for accurate diagnosis and treatment.

Purpose of the Study:

• To investigate the anatomical correlates of ictal fear in a patient with a parietal lobe seizure.
• To explore the electroclinical characteristics of seizures with prominent fear.
• To determine if limbic structures are necessary for the generation of ictal fear in parietal seizures.

Main Methods:

• Stereoelectroencephalography (SEEG) recording of a seizure with prominent fear.
• Quantification of the seizure onset zone using the Connectivity Epileptogenicity Index (cEI).
• Analysis of the relationship between fear occurrence and brain region involvement.

Main Results:

• The seizure onset was localized to the left inferior parietal cortex and superior temporal gyrus.
• Ictal fear was present without evidence of amygdala or other limbic network involvement.
• The Connectivity Epileptogenicity Index (cEI) method was used to quantify seizure onset.

Conclusions:

• Parietal lobe seizures can generate ictal fear independently of the limbic temporal network.
• The left inferior parietal cortex and superior temporal gyrus are implicated in the generation of ictal fear.
• This case expands the understanding of the neuroanatomical basis of ictal fear in epilepsy.