title: Autonomic auras: left hemispheric predominance of epileptic generators of cold shivers and goose bumps?
abstract: OBJECTIVE
  Autonomic seizures in temporal lobe epilepsies associated with "cold shivers and goose bumps" as a principal ictal sign or aura have only rarely been studied.
  
  
  METHODS
  Sixteen patients with autonomic auras [cold shivers or cold sweats (n=11), goose bumps (n=4), one patient showed both ictal signs] were analyzed.
  
  
  RESULTS
  Lesions were detected in 12 patients. The etiology was heterogeneous [cryptogenic, arteriovenous (AV)-malformation cyst, trauma, hippocampal sclerosis]. Eight patients underwent epilepsy surgery. The localization and lateralization of the focal epileptic activity in the temporal lobes was determined either by magnetic resonance imaging lesions, EEG, ictal signs, or single-photon emission computed tomography imaging.
  
  
  CONCLUSIONS
  The patients with temporal lobe epilepsies associated with "cold shivers and/or goose bumps" showed a left hemispheric predominance of the focal abnormality in the temporal lobe.
authors.affiliation: Department of Neurology-Center Epilepsy, University of Erlangen-Nürnberg, Germany. hermann.stefan@neuro.imed.uni-erlagen.de
authors.forename: H
authors.initials: H
authors.lastname: Stefan
authors.forename: E
authors.initials: E
authors.lastname: Pauli
authors.forename: F
authors.initials: F
authors.lastname: Kerling
authors.forename: A
authors.initials: A
authors.lastname: Schwarz
authors.forename: C
authors.initials: C
authors.lastname: Koebnick
mesh_terms: D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology*; D002540:Cerebral Cortex / Q000503:physiopathology*; D004292:Dominance, Cerebral; D004827:Epilepsy / Q000503:physiopathology*; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008032:Limbic System / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010863:Piloerection; D012768:Shivering