The "chapeau de gendarme" sign in focal epilepsy: A systematic review.

ABSTRACT: The "chapeau de gendarme" sign, also known as "ictal pouting," is a distinctive facial expression observed in focal epilepsy, characterized by a turned-down mouth with symmetrical lip and chin contraction. This systematic review investigates its clinical relevance, anatomical origins, and diagnostic value, particularly in presurgical evaluation. The sign is most commonly associated with mesial frontal epilepsy, particularly involving the anterior cingulate cortex (ACC), though moderate evidence links it to a broader network including insulo-opercular and temporo-parietal regions. Variability in semiologic descriptions and the absence of standardized definitions present challenges to its consistent recognition. Focal cortical dysplasia (FCD) was identified as the most frequent pathological

SUBMITTER: Moser K 

PROVIDER: S-EPMC12574494 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature