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July 1978

Seizures of Axial Structures: Presumptive Evidence for Brain Stem Origin

Author Affiliations

From the Division of Neurology, Long Island Jewish-Hillside Medical Center, and the Clinical Campus, School of Medicine, State University of New York-Stony Brook, New Hyde Park (Drs Nathanson and Biddle); and the Division of Neurology, Sinai Hospital, and the Johns Hopkins University, Baltimore (Dr Krumholz).

Arch Neurol. 1978;35(7):448-452. doi:10.1001/archneur.1978.00500310050010

• Scattered reports, both clinical and experimental, have been accumulating in the past 20 years indicating that true seizures may, indeed, originate from the brain stem and its immediate connections. Four cases are reported that give further strong presumptive evidence that this is so. All the seizures were confined to axial structures (face, tongue, palate, pharynx, diaphragm, and abdomen), and in one case each seizure had an identical "Jacksonian march." The phenomena were documented by 16-mm motion pictures, brain stem signs, and electroencephalography. The EEG consisted of periods of burst activity followed by relative interictal electrocerebral silence.

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