Thu11November0840AM 2

A 30-year-old man presents to the Emergency department with a history of epilepsy.

He starts to experience jerking movements of the angle left of his mouth and then progresses to having jerking movements of his left thumb and index finger. Finally, his entire left side develops jerking movements which subside in ten minutes.

After this he has a weakness down the left side for several hours. During the event he had full consciousness.

What is the likely diagnosis?

(Please select 1 option)

Temporal lobe seizure

Malingering

Jacksonian seizure Correct

Grand mal seizure

Myoclonic seizure

Explanation

A jacksonian seizure is also known as a focal (partial) motor seizure. In this condition an uncontrolled, spontaneous discharge of electricity from one motor cortex presents with contralateral motor signs. The patient has preserved consciousness as it is a partial seizure and after the seizure it is common to have a Todd's paralysis where the limb is weak.

Temporal lobe epilepsy presents with the sensation of déjà vu or an unreal feeling and can progress to hallucinations and altered conscious level.

Myoclonic seizures present with isolated muscle jerking.

In a grand mal seizure the electrical activity is throughout the cortex and consciousness is impaired and the patient may demonstrate tonic-clonic movements in all their limbs.

Reference:

Kumar P, Clark M. Kumar and Clark Clinical Medicine. 6th ed. London: Saunders; 2005.

Answer Statistics

1

14%

2

3%

3

70%

4

1%

5

15%

Times answered: 282