Rhythmic ictal nonclonic hand (RINCH) motions: a distinct contralateral sign in temporal lobe epilepsy.

Lee GR, Arain A, Lim N, Lagrange A, Singh P, Abou-Khalil B
Epilepsia. 2006 47 (12): 2189-92

PMID: 17201723 · DOI:10.1111/j.1528-1167.2006.00858.x

PURPOSE - To describe a new ictal sign in temporal lobe seizures-rhythmic ictal nonclonic hand (RINCH) motions and to determine its lateralizing significance and other ictal manifestations associated with it.

METHODS - We identified 15 patients with temporal lobe epilepsy who demonstrated RINCH motions and reviewed video-EEG recordings of all their seizures. We analyzed the epilepsy characteristics and all clinical features of recorded seizures, with particular attention to RINCH motions.

RESULTS - RINCH motions were unilateral, rhythmic, nonclonic, nontremor hand motions. RINCH motions were usually followed by posturing, sometimes with some overlap. They involved the hand contralateral to the temporal lobe of seizure onset in 14 of 15 patients.

CONCLUSIONS - RINCH motions are a distinct ictal sign that could be considered a specific type of automatism. They appear to be a lateralizing contralateral sign and are associated with dystonic posturing in temporal lobe epilepsy.

MeSH Terms (17)

Adult Automatism Basal Ganglia Diseases Child Dystonia Electroencephalography Epilepsy, Temporal Lobe Female Functional Laterality Hand Humans Magnetic Resonance Imaging Male Middle Aged Movement Disorders Treatment Outcome Videotape Recording

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