A typical child presents with an epigastric aura, followed by a quiet period of unresponsiveness with staring, lip- smacking, picking at sheets or clothes, contralateral dystonic posturing, and postictal confusion and lethargy. The probable diagnosis is
(B) Temporal lobe epilepsy # Temporal Lobe Epilepsy: Clinical manifestation of a seizure (seizure semiology) is also of localizing value.> For example, a typical patient with TLE may have an epigastric aura, followed by a quiet period of unresponsiveness with staring, lip-smacking (oral automatisms), picking at sheets or clothes (manual automatism), contralateral dystonic posturing, and postictal confusion and lethargy. If from the dominant hemisphere, there is usually delayed recovery of language, often with transient aphasia on testing. A typical frontal lobe seizure will occur from sleep with no warning, may show restlessness and/or prominent bilateral limb movements (such as bicycling or asymmetric tonic posturing), and will end quickly with immediate recovery; this may recur several times in one night. Occipital lobe seizures often have a visual aura, and may progress (due to electrical spread) into a temporal lobe or frontal lobe type of seizure. Parietal lobe seizures are the least common, may have a sensory aura, and tend to mimic frontal lobe seizures.> Differential Diagnoses: Absence Seizures; Frontal Lobe Epilepsy; Narcolepsy; Periodic Limb Movement Disorder; Tardive Dyskinesia.
Psychogenic seizures
Temporal lobe epilepsy
Panic disorder
Occipital lobe epilepsy
Miscellaneous