Third of three consecutive ictal EEG epochs an ongoing autonomic seizure during wakefulness

The duration of the seizure was 52 seconds from the onset of the sharp theta waves to the offset of the spike-wave activity. Shortly after the end of the seizure, EEG resumed its prior features with alpha rhythm on the occipital areas. The seizure consisted of hyperventilation and shortness of breathing at its very onset, followed by bilateral piloerection associated with a feeling of cold and then hot with sweating, nausea, and diffuse weakness while the patient’s awareness remained completely preserved. The seizure occurred in a 53-year-old man affected with lesional mesial temporal lobe epilepsy hamartomatous. (Contributed by Dr. R Cremascoli.)