Volvular epilepsy. A distinctive and underreported seizure type.

In a volvular seizure, the patient walks repetitively in small circles. This may form the whole of the attack or may precede a generalized tonoclonic seizure. It may be due to primary epilepsy or secondary to focal intracranial pathology. The direction of rotation may be ipsiversive or contraversive to the side of the epileptic focus. Although associated with complex partial and adversive seizures, it forms a distinctive entity, which may be due to involvement of the striatum. It has probably been underreported in the past. Four cases are reported herein.