Work

Ictal whistling as the first clinical sign of amygdala onset seizure on sEEG, a review of the literature and case report

Year: 2025

Type: article

Abstract: Ictal whistling (IW) is a rare type of mimic musical automatisms, which is usually reported in temporal lobe epilepsy. Accurate localization is crucial for the diagnosis and appropriate epilepsy treatment planning. In this report, we are describing a case of precise localization of ictal whistling seizures using intracranial stereo-EEG (sEEG). Clinically, symptoms were consistent with loss of awareness and mimic automatisms: whistling and blowing air, time-locked to an ictal pattern over the deep contacts of the left amygdala spreading promptly to the entire mesial hippocampal area. Although there was a structural abnormality (bilateral occipital horn heterotopia), it was not involved in the ictal pattern during the sEEG, which was crucial in determining our surgical options. We hypothesize that ictal whistling may be considered as an oroalimentary automatism, given that such symptoms are typically associated with seizure activity originating in the amygdala and peri-amygdaloid region.

Source: Medical Reports

DOI: 10.1016/j.hmedic.2025.100348

Authors: Ahmad Yusuf Solaiman, Mohammad Alkhoujah, Mo'men K. Kahhaleh

Institutions: Henry Ford Health, Henry Ford Hospital, Cleveland Clinic

Language: English

Topic: Epilepsy research and treatment

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $1,900