Ipsilateral and focal inhibitory seizures

Transient Paralytic Attacks of Obscure Nature: The Question of Non-Convulsive Seizure Paralysis

“…The left arm, although not involved by the seizure, became so weak for up to 12 hours after an attack that the patient could scarcely hold anything in the hand. In the case of Kofman and Tasker (1967), a marching numbness spread over the left side of the body, face, arm and leg, and the limbs became transiently weak, although they did not convulse. Rasmussen (1974) referred to somatic inhibitory seizures arising in the central region or in the supplementary motor area and in which paralysis preceded tonic or clonic movement by a few seconds.…”

Ictal hemiparesis

“…In some reports, investigative data are sparse and distinction from an ischaemic aetiology is difficult to make (Globus et al 1982, Dierckx et al 1988). However, in most cases a structural abnormality of the brain was determined and an EEG frequently showed slow activity, with or without sharp waves (Kofman andTasker 1967, Fisher 1978). Of note, however, is that a large number was diagnosed as 'ictal' in aetiology in view of the response of the hemiparesis to anticonvulsants, particularly benzodiazepines.…”

“…These two types have previously been separated by the timing of the paralysis with relation to the seizures, although they are probably pathologically similar. Higier's ictal paralytic phenomenon has also been called 'focal inhibitory seizure' (Kofman et al 1967), 'hemiparetic seizure' (Hanson et al 1978), and 'ictal hemiparesis' (Globus 1982). However, there have been few case-report descriptions of this phenomenon since 1950.…”

Ictal Hemiparesis

“…In the early cases, described by Jackson [5] and Collier [6], TIA or hemiplegic mi graine were not ruled out. Several cases were described during the last century: Hansen [7] in 1978 presented 3 children, Kofman and Tasker [3] described 2 adults, one of whom had focal inhibitory fits. In addition few cases were described where aphasia was the only symptom of the epileptic fit [11,12].…”

“…This paralytic equivalent of genuine epilepsy or hemiparetic seizure was first described by Higier [2] in 1916. Others have described this syndrome under the terms of 'focal inhibitory seizure' [3] or 'unilateral atonic seizure' [4). All au thors distinguished between an ictal hemi paretic attack and Todd's paralysis.…”