The diagnostic utility of the ictal cry

Epilepsy & Behavior : E&B
H ElzawahrySelim R Benbadis

Abstract

Epileptic generalized tonic-clonic (GTC) seizures are differentiated from nonepileptic spells primarily by history. The historical features that can aid in making a diagnosis, such as urinary incontinence and tongue biting, are few. One additional piece of information we propose may be of clinical value is the stereotypical "ictal cry." We reviewed audio from 20 consecutive GTC seizures and 20 consecutive psychogenic convulsive nonepileptic spells recorded in our epilepsy monitoring unit. The audio components of the recordings from each group were compared. The typical laryngeal sound was found to have both high sensitivity (85%) and specificity (100%) for epileptic GTC seizures. In none of the 20 psychogenic cases was the typical epileptic vocalization expressed; these cases were mostly associated with other utterances such as weeping, moaning, and coughing. The ictal cry is strongly associated with epileptic GTC seizures and, thus, warrants inquiry when obtaining the history from witnesses of a patient's seizure.

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Citations

Mar 28, 2012·Current Opinion in Psychiatry·Markus Reuber, Rebecca Mayor
Jun 2, 2012·Epilepsy & Behavior : E&B·Robert S FisherJacqueline A French
Mar 1, 2012·Annals of Neurology·Robert S Fisher
May 21, 2016·Seizure : the Journal of the British Epilepsy Association·Mariel VelezScheherazade Le
Oct 1, 2016·Epilepsia·Marije van der LendeRoland D Thijs
Sep 23, 2018·Neurology·Marije van der LendeRoland D Thijs
Oct 28, 2019·Movement Disorders : Official Journal of the Movement Disorder Society·Tina MainkaChristos Ganos
Mar 22, 2018·European Heart Journal·Michele BrignoleUNKNOWN ESC Scientific Document Group
Apr 11, 2020·Seizure : the Journal of the British Epilepsy Association·Jennifer ShumDaniel Friedman

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