Pearls and Oy-sters: The chapeau de gendarme sign and other localizing gems in frontal lobe epilepsy.

Localization of ictal pouting in frontal lobe epilepsy: A case report

Changes in facial expression in frontal lobe epilepsy (FLE) have been described in the literature [1,2]. However, this discrete feature of ictal semiology is often missed because of more striking events such as hypermotor or bizarre behaviors. One such facial feature, characterized by a turned-down mouth, is traditionally described in French as the “chapeau de gendarme,” referring to the shape ...

Pearls and oy-sters: ictal syncope in a patient with temporal lobe epilepsy.

PEARLS & OY-STERS: ICTAL SYNCOPE IN A PATIENT WITH TEMPORAL LOBE EPILEPSY Nitin K. Sethi, New York: Varade et al. reported ictal syncope in a patient with temporal lobe epilepsy (TLE). The MRI revealed a right temporal-occipital cavernous angioma and the seizure showed onset in the right posterior temporal electrode (T6) on EEG, all compatible with a diagnosis of symptomatic localization-relate...

Pearls & oy-sters: hyperdense or pseudohyperdense MCA sign: a Damocles sword?

• The presence of a true hyperdense sign can be confirmed by measuring attenuation value as compared to the normal-appearing contralateral side. • Mimics of a hyperdense sign (i.e., a pseudohyperdense sign) include vascular calcification, raised hematocrit, and intravenous contrast medium. • Careful attention should also be paid to the surrounding brain parenchyma to assess for hypodensity or a...

Pearls & oy-sters: cerebral venous air embolism after central catheter removal: too much air can kill.

Pearls & Oy-sters: cough headache secondary to Chiari malformation type I.