PAINFUL GENERALIZED CLONIC AND TONIC-CLONIC SEIZURES WITH RETAINED CONSCIOUSNESS

Two patients in whom consciousness and memory were retained during bil ateral clonic or tonic-clonic seizures are reported on, and three pati ents reported on previously are reviewed. Ictal semiology differed fro m myoclonic and supplementary motor seizures, which are other seizure types characterised by bilateral motor movements and retained awarenes s. In the two new patients ictal pain was a prominent feature. It is p roposed that propagation of seizure activity may be confined to the se nsorimotor areas bilaterally while sparing the neural structures invol ved in maintaining consciousness and in processing language and memory . This unusual type of seizure may be misdiagnosed as a pseudoseizure. Detailed description of the ictal events and further laboratory evalu ation including video-EEG monitoring may be necessary to make the dist inction.