title: Ictal verbal help-seeking: Occurrence and the underlying etiology.
abstract: Ictal verbal help-seeking has never been systematically studied before. In this study, we evaluated a series of patients with ictal verbal help-seeking to characterize its frequency and underlying etiology.
  
  
  
  We retrospectively reviewed all the long-term video-EEG reports from Jefferson Comprehensive Epilepsy Center over a 12-year period (2004-2015) for the occurrence of the term "help" in the text body. All the extracted reports were reviewed and patients with at least one episode of documented ictal verbal help-seeking in epilepsy monitoring unit (EMU) were studied. For each patient, the data were reviewed from the electronic medical records, EMU report, and neuroimaging records.
  
  
  
  During the study period, 5133 patients were investigated in our EMU. Twelve patients (0.23%) had at least one episode of documented ictal verbal help-seeking. Nine patients (six women and three men) had epilepsy and three patients (two women and one man) had psychogenic nonepileptic seizures (PNES). Seven out of nine patients with epilepsy had temporal lobe epilepsy; six patients had right temporal lobe epilepsy.
  
  
  
  Ictal verbal help-seeking is a rare finding among patients evaluated in epilepsy monitoring units. Ictal verbal help-seeking may suggest that seizures arise in or propagate to the right temporal lobe.
authors.affiliation: Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: aliasadipooya@yahoo.com.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Asadi-Pooya
authors.affiliation: Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: marjan.asadollahi@jefferson.edu.
authors.forename: Marjan
authors.initials: M
authors.lastname: Asadollahi
authors.affiliation: Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA. Electronic address: kbujarski@gmail.com.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Bujarski
authors.affiliation: Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: amin.rabiei@jefferson.edu.
authors.forename: Amin H
authors.initials: AH
authors.lastname: Rabiei
authors.affiliation: Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: Narsis.Aminian@jefferson.edu.
authors.forename: Narsis
authors.initials: N
authors.lastname: Aminian
authors.affiliation: Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: dale.wyeth@jefferson.edu.
authors.forename: Dale
authors.initials: D
authors.lastname: Wyeth
authors.affiliation: Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: michael.sperling@jefferson.edu.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Sperling
mesh_terms: D000328:Adult; D000368:Aged; D004569:Electroencephalography / Q000379:methods; D005260:Female; D000066505:Help-Seeking Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D059906:Neuroimaging; D012189:Retrospective Studies; D012640:Seizures / Q000523:psychology*; D014705:Verbal Behavior; D055815:Young Adult
keywords: Epilepsy; Help; Ictal; Psychogenic; Seizure