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August 1969

Automatisms Associated With the Absence of Petit Mal Epilepsy

Author Affiliations

Bethesda, Md; Charlottesville, Va
From the Section on Epilepsy, Collaborative and Field Research, National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, Md (Dr. Penry), and the Department of Neurology, University of Virginia School of Medicine, Charlottesville, Va (Dr. Dreifuss).

Arch Neurol. 1969;21(2):142-149. doi:10.1001/archneur.1969.00480140042004

AUTOMATISMS have long attracted the neurologist's attention, but their occurrence has become too widely regarded as a pathognomonic sign of temporal lobe epilepsy. Since Penfield1 reported the production of automatisms by stimulating gray matter of mesial temporal lobe adjacent to the insula, many neurologists have inferred that an automatism is synonymous with a discrete discharging focus in the temporal lobe. The designation of "temporal lobe automatisms" used by investigators2 in describing clinical neurophysiologic studies has led to the general assumption that automatisms occurring in temporal lobe epilepsy have specific characteristics which set them apart from other automatisms.3 This notion evolved in spite of well documented descriptions of automatisms in association with the absence attacks of petit mal epilepsy; indeed "absence with automatisms" is an integral part of the nonfocal section of the international classification.4

This study was conducted to determine the nature of automatisms which occur