Although a nonspecific cephalic sensation, the so-called "cephalic
aura," is a common sensory
aura, particularly in frontal lobe
seizures, but is rarely is the entire
sensory seizure event. The unusual presentation of cephalic sensations in isolation representing supplementary motor area (SMA)
seizures, which are commonly unaccompanied by ictal electroencephalography (EEG) changes, can easily lead to misdiagnosis of nonepileptic psychogenic
seizures. We illustrate the case of a 36-year-old male patient with
frontal lobe epilepsy who presented with isolated cephalic
auras described as a nonvertiginous sense of head movement without observable clinical signs after his habitual partial
motor seizures were controlled with
pharmacotherapy. Video/EEG recordings showed no recognizable epileptic discharges time-locked to the onset of the isolated cephalic
auras. Ictal magnetoencephalography (MEG) with synthetic aperture magnetometry-kurtosis (SAM(g(2))) analysis demonstrated the SMA onset of the cephalic
auras; thus, MEG was essential in differentiating these isolated
auras from nonepileptic psychogenic events.