title: Sign of the Cross (Signum Crucis): observation of an uncommon ictal manifestation of mesial temporal lobe epilepsy.
abstract: The objective of the study was to describe the clinical characteristics and determine the lateralizing value of ictal Sign of the Cross (SC) as a complex hand automatism (CHA) in patients evaluated by video/EEG monitoring in a comprehensive epilepsy unit. We reviewed video/EEG data of 530 patients with epilepsy recorded in a tertiary epilepsy center from 2002 to 2008. Four patients were found to have manifested a CHA similar to the SC at least once during their complex partial seizures. All patients had unilateral right mesial temporal lobe epilepsy (TLE) refractory to medical treatment. The limbic system is often suggested as the critical site of religious experience. Moreover, it may be localized predominantly to the temporal regions of the right hemisphere. However, this rare and peculiar ictal manifestation may be related not only to the neural substrate and personality characteristics of TLE, but also to the general religious convictions of Brazilians.
authors.affiliation: Unidade de Pesquisa e Tratamento das Epilepsias, Universidade Federal de São Paulo EPM, São Paulo, Brazil. linkatia@uol.com.br
authors.forename: Katia
authors.initials: K
authors.lastname: Lin
authors.forename: Catherine
authors.initials: C
authors.lastname: Marx
authors.forename: Luis O S F
authors.initials: LO
authors.lastname: Caboclo
authors.forename: Ricardo S
authors.initials: RS
authors.lastname: Centeno
authors.forename: Américo C
authors.initials: AC
authors.lastname: Sakamoto
authors.forename: Elza M T
authors.initials: EM
authors.lastname: Yacubian
mesh_terms: D000293:Adolescent; D000328:Adult; D001332:Automatism / Q000209:etiology*; D002648:Child; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000150:complications* / Q000523:psychology*; D005260:Female; D007839:Functional Laterality; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D019370:Observation / Q000379:methods; D012067:Religion; D012189:Retrospective Studies; D014741:Video Recording / Q000379:methods