TY - JOUR
T1 - Teaching Video NeuroImage
T2 - Rhythmic Ictal Nonclonic Hand Motions: A Valuable Lateralizing Sign in Focal Epilepsy
AU - Marcinski Nascimento, Kaley J.
AU - King, Alexis
AU - Beniczky, Sándor
AU - Nascimento, Fábio A.
N1 - Publisher Copyright:
© 2025 American Academy of Neurology.
PY - 2025/1/15
Y1 - 2025/1/15
N2 - We report a 34-year-old right-handed woman with a history of nonlesional (MRI and interictal FDG-PET negative), drug-resistant, adult-onset focal epilepsy who was admitted to the epilepsy monitoring unit for presurgical evaluation. Semiology was described as a rising sensation in her chest/head, déjà vu, and occasionally a metallic taste in her mouth followed by whole body shaking. Video-scalp EEG evaluation captured habitual seizures whose semiology consistently included right rhythmic ictal nonclonic hand (RINCH) motions (Video 1). Scalp EEG showed ictal activity with onset in the left temporal region (Figure, Video 2). Electroclinical data were consistent with a focus in the left temporal region. These data guided the recommendation to perform a stereo-EEG investigation where the left temporal topography is sampled.
AB - We report a 34-year-old right-handed woman with a history of nonlesional (MRI and interictal FDG-PET negative), drug-resistant, adult-onset focal epilepsy who was admitted to the epilepsy monitoring unit for presurgical evaluation. Semiology was described as a rising sensation in her chest/head, déjà vu, and occasionally a metallic taste in her mouth followed by whole body shaking. Video-scalp EEG evaluation captured habitual seizures whose semiology consistently included right rhythmic ictal nonclonic hand (RINCH) motions (Video 1). Scalp EEG showed ictal activity with onset in the left temporal region (Figure, Video 2). Electroclinical data were consistent with a focus in the left temporal region. These data guided the recommendation to perform a stereo-EEG investigation where the left temporal topography is sampled.
UR - http://www.scopus.com/inward/record.url?scp=85216004875&partnerID=8YFLogxK
U2 - 10.1212/WNL.0000000000213346
DO - 10.1212/WNL.0000000000213346
M3 - Article
C2 - 39813631
AN - SCOPUS:85216004875
SN - 0028-3878
VL - 104
JO - Neurology
JF - Neurology
IS - 3
M1 - e213346
ER -