Evidence map›Paper›PMID 42094181›Full record

ArticleEpilepsy & behavior reports2026

Goosebumps and chills: bilateral piloerection as a manifestation of right mesial temporal epilepsy.

Brianna Fowler, Syeda Amrah Hashmi, Howard P Goodkin, Patrick Hartnett, Heather Spader, Farsam Abbas, Ifrah Zawar

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Epilepsy & behavior reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Brianna FowlerDepartment of Neurology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Syeda Amrah HashmiDepartment of Neurology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Howard P GoodkinDepartment of Neurology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Patrick HartnettDepartment of Neurology, Hartford Healthcare, Hartford, CT, USA.
Heather SpaderDepartment of Neurology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Farsam AbbasDepartment of Neurology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Ifrah ZawarDepartment of Neurology, University of Virginia School of Medicine, Charlottesville, VA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Ictal piloerection is a rare autonomic seizure manifestation that can obscure localization and mimic non-epileptic conditions. We report a 21-year-old man with drug-resistant focal epilepsy whose seizures consisted of isolated bilateral piloerection and chills followed by coughing. MRI demonstrated right mesial temporal sclerosis, and FDG-PET showed concordant hypometabolism. Scalp EEG suggested a right temporal onset. Stereo-electroencephalography recorded eleven habitual seizures with electrographic onset in the right amygdala and hippocampus preceding the clinical symptoms. Notably, cortical stimulation of both structures reproducibly elicited bilateral piloerection, directly confirming their role in symptom generation. Following laser ablation of the right amygdala and hippocampus, the patient remains seizure-free at ten months. This case is unique in providing intracranial and stimulation-based evidence for bilateral ictal piloerection arising from a unilateral mesial temporal focus involving both the amygdala and hippocampus. Recognition of this distinctive autonomic semiology and its localization is critical, as it refines localization, guides strategic sEEG implantation, and underscores the need for comprehensive limbic coverage in surgical planning to optimize seizure freedom.

Indexed as

AmygdalaCortical stimulationIctal piloerectionPilomotor seizuresStereo-electroencephalography (sEEG)

Identifiers

PMID42094181
PMCPMC13141775

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.