11/3/2023 0 Comments Nightmare aura definitionThe revised 2015 ILAE status epilepticus classification utilizes 4 axes: (1) seizure semiology, (2) etiology, (3) EEG correlates, and (4) age to classify status epilepticus ( 82). Wolf used it as synonym for "status epilepticus of focal sensory seizures" or for hallucinosis ( 103). The term "aura continua" can be found in Karbowski as a synonym for continuous psychomotor status ( 42 98). Scott and Masland first describe somatosensory hallucinations as a "continuous symptom" of an "aura continua” ( 70). In the case of a focal aware seizure, the aura is the entire seizure however, where awareness is subsequently impaired, the aura is, in fact, the first symptom of a focal seizures with impaired awareness ( 20). The term "aura" usually refers to that portion of a seizure experienced before impaired awareness occurs and for which memory is retained. made up of some cells, not of the uncinate gyrus alone, but of some cells of different parts of a region of which this gyrus is part. However, it was the post mortem finding of a small cystic lesion restricted to the uncinate gyrus in a patient who had suffered from seizures with dreamy states, elaborated automatisms, and amnesia ( 39) that led Jackson and Stewart to the concept of "uncinate fits" with "origin of the discharge lesion. Anderson as well as Jackson and Beevor had noted the association of temporal lobe tumors with olfactory hallucinations and dreamy states ( 38 02). In 1748, Robert Whyatt had described such a condition with gelastic seizures and olfactory aura ( 91). Jackson’s concept of "a particular variety of epilepsy" ( 40), the "uncinate fits," also had forerunners. ![]() John Hughlings Jackson (1835-1911) described what was later called psychomotor attack by Gibbs and colleagues ( 27). as far as to the head and as soon as it has touched the latter he was no longer able to follow.” Although the patient himself could not tell what exactly rose up, another youth, a better observer, said "that it was like a cold breeze" ( 25). Galen coined the term aura (taken from the Greek and originally meaning "breeze") by describing a 13-year-old boy who explained that the condition "originated in the lower leg and then from here climbed upwards. Treatment of aura continua is often difficult and complete seizure freedom is not always possible.Aura continua has varied clinical manifestations, depending on the cortical region of origin, and is often associated with an underlying focal cortical lesion.Therapeutic medication trials or specialized testing may be needed to firmly establish the diagnosis.Aura continua is a rare phenomenon, difficult to diagnosis, and often occurring with other forms of seizures in the same individual.As with epilepsia partialis continua, the motor counterpart to aura continua, the understanding of the nature of the aura continua in terms of exact pathophysiology awaits clarification. Rarely, such symptoms last hours to days (and rarely even years) and are then called “aura continua,” ie, representing a form of focal status epilepticus. ![]() If an aura occurs in isolation without further progression, it is more appropriately called a focal aware seizure, according to the 2017 ILAE Classification of the Epilepsies. ![]() Typically, an aura lasts seconds to minutes, is stereotyped, and evolves to other ictal clinical features, including loss of awareness. Focal seizures may begin with a somatosensory, special sensory, visceral, or experiential aura, depending on the localization of the epileptic discharge and on the accuracy of documentation.
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