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Seizure semiology of anti-LGI1 antibody encephalitis Volume 19, issue 4, December 2017

Digital EEG recording with time-locked video of seizures in a patient with LGI1 encephalitis. Electrodes were placed in accordance with the 10-20 international system of electrode placement and included 21 channels, single-lead EKG monitoring, as well as temporal electrodes (T1 and T2). A total of four seizures are shown. The first seizure occurs out ofNREMsleep with semiology of right-hand and oral automatisms, variably comprehensible ictal speech, vocalization, and distressed affect, with an ictal EEG correlate of rhythmic delta activity over the right hemisphere, maximal in the right temporal region. The second seizure occurs during wakefulness and is characterized by the patient starting to ask a question when she develops a brief dystonic contraction of the left side of the face, followed by non-fluent aphasia with an ictal EEG correlate of rhythmic delta activity over the left temporal region. The third seizure occurs during wakefulness and starts with rapid right-hand automatisms, followed by a grimacing facial expression during conversation, with an ictal EEG correlate of rhythmic right temporal delta activity. The fourth seizure starts with right-hand automatisms, followed by ictal speech, distressed affect, and yelling, with an ictal EEG correlate starting as rhythmic delta activity over the right temporal region, evolving to the left temporal region.

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