Ictal Nose Wiping in a Patient with Mesial Temporal Lobe Epilepsy / 대한간질학회지

Seizure-associated nose wiping occurs usually during postictal period and is more frequent in temporal than extratemporal lobe epilepsy. The hand used to wipe the nose is highly suggestive of ipsilateral partial seizure onset. We describe a patient with the left mesial temporal lobe epilepsy, who showed ictal nose wiping by the left hand. The hypothetical mechanism remains unknown but may be a response to olfactory aura or increased ictal nasal secretions. In this patient, subtraction ictal SPECT coregistered to MRI (SISCOM) study revealed hyperperfusion mainly in the left temporal lobe, especially amygdala. Our patient may support an important role of amygdala concerned with olfactory system or autonomic activity in provoking nose wiping.