Abstract Details

Title Touch-Screen Automatisms With Stereotyped Postictal Texting Behavior In A Case Of Drug And Surgical Refractory Epilepsy

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 11-011

Objective

To describe a patient with drug and surgery refractory epilepsy with an atypical post-ictal behavior following focal onset impaired awareness behavioral arrest epileptic seizures with touch-screen automatisms.

Background A 34-year-old right-hand dominant woman was admitted to an epilepsy monitoring unit for characterization of new events concerning for seizures. These events consisted of repetitive eye blinking, behavioral arrest, lip smacking and vocalizations, along with trace nonrhythmic left-hand movements with her cell phone consistent with touch-screen automatisms. These seizures were followed by 10–20 minutes retrograde amnesia, during which the patient would send a text message to the same 3 individuals on her phone: “What is your home address?” MRI brain was nonlesional, and vEEG demonstrated increased beta activity in the right mid-temporal region (T4) with evolution to rhythmic delta activity spreading to the right anterior temporal, and then frontal regions, subsequently generalizing to both hemispheres. Status post right anterior temporal lobectomy, she is now having only nocturnal seizures originating from the left temporal lobe while also on Cenobamate, Lacosamide, and Clobazam; Engel Classification IID.

Design/Methods N/A

Results N/A

Conclusions This case highlights a unique post-ictal behavior of repetitively texting the same contacts for the patient's home address. This behavior appears to be a reliable marker of the patient's ongoing focal seizures and may serve as a useful biomarker to track her response to treatment. A literature review demonstrates that texting behavior has never been reported in relation to ictal or post-ictal processes. Although there have been reports of patterns associated with texting, this is the first time such behavior has been documented in the literature. The patient is scheduled for surgical evaluation, and if a focus is identified, it could provide valuable information about the underlying seizure focus. Additionally, it could potentially serve as a biomarker to track seizure activity and response to surgical treatment.

Authors/Disclosures
Luca Micci, MD (Walter Reed National Military Medical Center) PRESENTER	Dr. Micci has nothing to disclose.
Angelica M. Lee, DO (Uniformed Services University of the Health Sciences)	Dr. Lee has nothing to disclose.

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