Autonomic auras: Left hemispheric predominance of epileptic generators of cold shivers and goose bumps?

Summary: Purpose: 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 4 11), goose bumps (n 4 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. Key Words: Visceral—Autonomic epilepsy— Aura—Temporal lobe epilepsy—Lateralization—Presurgical evaluation.