Ictal dancing associated with hippocampal sclerosis

Ictal dancing is a very rare seizure semiology. Five cases have been previously reported in the literature [1–4]. Even though one case report investigated with stereo-encephalography (SEEG) showing intracranial ictal EEG change arising from right prefrontal region, particularly right dorsolateral prefrontal area in patients with ictal singing associated with dancing, underlying mechanisms and the neural basis of ictal dancing remain unknown [4]. This report presents one more case of ictal dancing in a temporal lobe epilepsy (TLE) patient with pathologically-confirmed hippocampal sclerosis (HS). A 27-year-old right-handed woman suffered from medically intractable TLE. Her seizure began at the age of 10 and consisted of (1) isolated aura; (2) aura with automotor seizure; and (3) secondarily generalized tonic clonic seizure (GTC). Aura is described as palpitation and fear. Despite treatment with several antiepileptic drugs (AEDs), her seizure persisted on a weekly basis. She also had one episode of simple febrile convulsion at the age of 3. She was admitted to the epilepsy monitoring unit in our center for pre-surgical evaluation. Four habitual seizures were recorded. Three of them were aura with automotor seizure. The other was initially similar but was followed by a GTC. All four seizures consistently started with autonomic (palpitation) and affective (fear) aura then followed by oral and bimanual automotor seizure. During two seizures, different patterns of associated complex motor behavior including acting out a dance move was observed