title: Semiology of the rare seizure subtype piloerection.
abstract: OBJECTIVE
  To report piloerection and vasomotor instability as a sole manifestation of partial seizures.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Inpatient tertiary care center.
  
  
  METHODS
  A 72-year-old man with acute onset of repetitive autonomic events.
  
  
  METHODS
  Extensive cardiovascular evaluation, electroencephalographic testing, radiology, laboratory assessment, and frequency of clinical events (seizures).
  
  
  RESULTS
  We characterize an uncommon manifestation of right temporal lobe partial seizures, initially thought to be cardiovascular in origin, as pilomotor seizures accompanied by other autonomic phenomena. The ictal electroencephalogram recordings established the diagnosis of right temporal lobe seizures, and head magnetic resonance imaging demonstrated right mesial temporal T2 signal change, enhancement, and subsequent atrophy. The underlying etiology was not uncovered despite an extensive laboratory and radiological evaluation. However, given the history and imaging findings, an infectious or secondary immunological etiology was suspected.
  
  
  CONCLUSIONS
  Pilomotor events with other transient autonomic features, such as tachycardia and blood pressure fluctuations, may represent localization-related epilepsy. The acute onset of these events accompanied by other autonomic phenomena in the setting of focal magnetic resonance imaging abnormalities within the hippocampal region raises questions concerning pilomotor seizures as well as the differential diagnosis of acute seizure activity in the setting of neuroimaging findings characteristic for limbic encephalitis.
authors.affiliation: Department of Neurology, Mayo Clinic Rochester, MN 55905, USA. lam.erek@mayo.edu
authors.forename: Erek M
authors.initials: EM
authors.lastname: Lam
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Worrell
authors.forename: Ruple S
authors.initials: RS
authors.lastname: Laughlin
mesh_terms: D000368:Aged; D004569:Electroencephalography / Q000379:methods; D006257:Head / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010863:Piloerection / Q000502:physiology*; D012640:Seizures / Q000473:pathology / Q000503:physiopathology*