Mimetic automatisms expressing a negative affect in two patients with temporal lobe epilepsy

Ryan S. Hays, Neeta Lal, Joshua Rosenow, Michael P. Macken, Stephan U. Schuele

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Ictal automatisms of fear or sadness, of which the patient is unaware and which are not preceded by a corresponding emotion, have not been well characterized. Of 557 patients admitted for video/EEG monitoring, 2 (0.36%) were identified who had automatisms of fear and sadness. One patient was found to have a sudden ictal expression of sadness of which he was not aware. The second patient showed a sudden fearful expression, followed by oral automatisms, staring, and amnesia for the event. Both patients had left mesial temporal lobe epilepsy. The patient with ictal fear underwent further invasive monitoring and became seizure free after a limited mesial temporal resection. The mesial temporal structures not only mediate emotional experiences, but can also activate stereotyped expressions of fear or sadness without the patient's awareness, arguing for an efferent pathway for expressing negative affects within the mesial temporal lobe.

Original languageEnglish (US)
Pages (from-to)572-578
Number of pages7
JournalEpilepsy and Behavior
Issue number3
StatePublished - Mar 1 2011


  • Amygdala
  • Anterior cingulate
  • Mimetic automatisms
  • Negative affect
  • Temporal lobe epilepsy
  • Video electroencephalographic monitoring

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience


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