{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T13:57:10Z","timestamp":1772632630457,"version":"3.50.1"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Seizure semiology reflects dynamic interactions among ictal activity, internal state, and environmental context, and often involves distributed neural networks beyond the epileptogenic focus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We report a 27-year-old right-handed, blind, bilingual man with focal epilepsy whose seizures were characterized by intense fear of imminent death, loud and coherent vocalizations, context-dependent bilingual language use, accurate autobiographical references, preserved responsiveness, and complete postictal amnesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During seizures, the patient consistently addressed his mother in Urdu or English while speaking exclusively in English to medical staff, demonstrating preserved pragmatic awareness; nevertheless, he had no recollection of events afterward and expressed surprise when he heard his ictal vocalizations on the recorded video. Brain MRI revealed a left middle cranial fossa arachnoid cyst abutting the medial temporal lobe and ictal onset was in the right anterior temporal region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case expands the spectrum of ictal fear and ictal speech by illustrating the convergence of multilingual communication, autobiographical integration, and pure postictal amnesia, highlighting the engagement of distributed limbic, interoceptive, and medial frontal networks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1784636","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:03:35Z","timestamp":1772607815000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ictal fear of death with preserved context dependent speech and postictal amnesia in focal epilepsy"],"prefix":"10.3389","volume":"17","author":[{"given":"Christopher","family":"Saouda","sequence":"first","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, George Washington University","place":["Washington, DC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasmeen","family":"Kassem-Scott","sequence":"additional","affiliation":[{"name":"Department of Neuroscience and Behavior, Vassar College","place":["Poughkeepsie, NY, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elham","family":"El Hallak","sequence":"additional","affiliation":[{"name":"Harvard Center for Brain Science, Harvard University","place":["Cambridge, MA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prarthana","family":"Hareesh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Wellspan Health","place":["Chambersburg, PA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Vinarsky","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, George Washington University","place":["Washington, DC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Eid","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, George Washington University","place":["Washington, DC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yamane","family":"Makke","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, George Washington University","place":["Washington, DC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad Zakaria","family":"Koubeissi","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, George Washington University","place":["Washington, DC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1093\/scan\/nsq106","article-title":"Existential neuroscience: a functional magnetic resonance imaging investigation of neural responses to reminders of one\u2019s mortality","volume":"7","author":"Quirin","year":"2012","journal-title":"Soc Cogn Affect Neurosci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1038\/sj.mp.4000812","article-title":"The amygdala: Vigilance and Emotion","volume":"6","author":"Davis","year":"2001","journal-title":"Mol Psychiatry"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1673","DOI":"10.1093\/brain\/113.6.1673","article-title":"Experiential phenomena of temporal lobe epilepsy: facts and 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