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This paper provides an accessible review of the biological and psychological evidence to guide new and experienced researchers in the study of emotional piloerection in humans. A limited number of studies have attempted to examine the physiological and emotional correlates of piloerection in humans. However, no review has attempted to collate this evidence to guide the field as it moves forward. We first discuss the mechanisms and function of non-emotional and emotional piloerection in humans and animals. We discuss the biological foundations of piloerection as a means to understand the similarities and differences between emotional and non-emotional piloerection. We then present a systematic qualitative review (k = 24) in which we examine the physiological correlates of emotional piloerection. The analysis revealed that indices of sympathetic activation are abundant, suggesting emotional piloerection occurs with increased (phasic) skin conductance and heart rate. Measures of parasympathetic activation are lacking and no definite conclusions can be drawn. Additionally, several studies examined self-reported emotional correlates, and these correlates are discussed in light of several possible theoretical explanations for emotional piloerection. Finally, we provide an overview of the methodological possibilities available for the study of piloerection and we highlight some pressing questions researchers may wish to answer in future studies.

In scientific and popular literature, piloerection (e.g. goosebumps) is often claimed to accompany the experience of awe, though this correlation has not been tested empirically. Using two pre-registered and independently collected samples (N = 210), we examined the objective physiological occurrence of piloerection in response to awe-inducing stimuli. Stimuli were selected to satisfy three descriptors of awe, including perceptual vastness, virtual reality, and expectancy-violating events. The stimuli reliably elicited self-reported awe to a great extent, in line with previous research. However, awe-inducing stimuli were not associated with the objective occurrence of piloerection. While participants self-reported high levels of goosebumps and “the chills,” there was no physical evidence of this response. These results suggest that piloerection is not reliably connected to the experience of awe—at least using stimuli known to elicit awe in an experimental setting.

Situations involving increased closeness or exceptional kindness are often labeled as moving or touching and individuals often report bodily symptoms, including tears, goosebumps and warmth in the body. Recently, the kama muta framework has been proposed as a cross-cultural conceptualization of these experiences. Prior research on kama muta has mostly relied on subjective reports. Thus, our main goal of the present project was to examine the pattern of physiological responses to kama muta inducing videos and compare it to the patterns for the similar, though distinct emotions of sadness and awe. One hundred forty-four Portuguese and Norwegian participants were individually exposed to all three emotion conditions. Several psychophysiological indexes of the autonomic nervous system were collected continuously during exposure, including cardiovascular, respiratory, and electrodermal activity, facial EMG, skin temperature, as well as piloerection and lachrymation using cameras. Overall, the results partly replicated previous findings on being moved experiences and self-report studies. Strong self-reported experiences of kama muta were associated with increased phasic skin conductance, skin temperature, piloerection, and zygomaticus activity, while they were associated with reduced heart rate, respiration rate, and tonic skin conductance. The physiological profile of kama muta was successfully distinguished from sadness and awe, partly corroborating self-report evidence. We obtained no clear evidence of a kama muta association with the occurrence of lachrymation or heart rate variability. Our findings provide a systematic overview of psychophysiological response to experiences of kama muta, and help to inform future research on this emotion and positive emotions in general. info:eu-repo/semantics/publishedVersion

Piloerection (goosebumps) requires concerted actions of the hair follicle, the arrector pili muscle (APM), and the sympathetic nerve, providing a model to study interactions across epithelium, mesenchyme, and nerves. Here, we show that APMs and sympathetic nerves form a dual-component niche to modulate hair follicle stem cell (HFSC) activity. Sympathetic nerves form synapse-like structures with HFSCs and regulate HFSCs through norepinephrine, whereas APMs maintain sympathetic innervation to HFSCs. Without norepinephrine signaling, HFSCs enter deep quiescence by down-regulating the cell cycle and metabolism while up-regulating quiescence regulators Foxp1 and Fgf18. During development, HFSC progeny secretes Sonic Hedgehog (SHH) to direct the formation of this APM-sympathetic nerve niche, which in turn controls hair follicle regeneration in adults. Our results reveal a reciprocal interdependence between a regenerative tissue and its niche at different stages and demonstrate sympathetic nerves can modulate stem cells through synapse-like connections and neurotransmitters to couple tissue production with demands.

People can be moved and overwhelmed, a phenomenon typically accompanied by goose-bumps and tears. We argue that these feelings of being moved are not limited to situations that are appraised as pro-social but elicited when someone surpasses an internal standard. In line with these predictions, people were moved by relationships and success (Study 1), by reunion, separation, success and failure (Study 2) and by social, environmental and sports achievements (Study 3). In all three studies, the elicitation of these feelings was partially mediated by appraisals of surpassing social or achievement standards. In line with this, ratings of meaningfulness were closely associated with feelings of being moved and moving stimuli elicited behavioural intentions such as spending time with family and friends, helping others and/or achieving something in life. Thus, moving situations may remind us about what we perceive as meaningful and thereby help us to act accordingly.

PURPOSE: To comprehensively analyze ictal piloerection (IP) in a large number of subjects.METHODS: We performed a systematic review on case report studies of patients diagnosed with IP (1929-2017) with additional cases included from the Department of Neurology of University of Pécs, the National Institute of Clinical Neurosciences, and Odense University Hospital. Each included case was characterized regarding patient history, IP seizure characteristics, diagnostic work-up, and therapy. Comparative analyses were also carried out based on sex and pathology.RESULTS: Altogether, 109 cases were included. We observed a strong male predominance (p CONCLUSION: IP was particularly associated with autoimmune encephalitis and high-grade glioma, suggesting IP's particular clinical importance in directing diagnostic work-up.

Objective We previously reported the first case of piloerection in a patient receiving milnacipran hydrochloride (MLP). Here, we now present a second case of MLP-induced piloerection. We discuss this effect in terms of α1-adrenoceptor occupancy. Case summary After the first case of MLP-induced piloerection, we monitored occurrence of piloerection in our patients taking MLP. In response to our interview, a 43-year-old woman who had been prescribed MLP by a psychiatrist for depression mentioned that piloerection occurred frequently all over her body, starting soon after initiation of MLP administration (50 mg/day). Although she was concerned at the time, she assumed it might be related to her depression or to coldness in winter. She also mentioned that the incidence of piloerection increased with MLP dose escalation. The piloerection disappeared after several months. Interestingly, the previous patient and the current patient are biological sisters. Discussion Changes in α1-adrenoceptor occupancy by endogenous norepinephrine (as an index of the risk of piloerection) in the presence of MLP were estimated. The occupancy values increased with MLP dose escalation, in accordance with the patient's report of the phenomenon. other concomitant drugs, such as nortriptyline, had little effect. Since the two patients were sisters, genetic factors might influence the risk of piloerection. Conclusion The incidence of piloerection appeared to increase with MLP dose escalation in this patient, who was the biological sister of the previously reported patient. Clinicians should recognize the possibility of MLP-induced piloerection in view of its potential impact on patients' quality of life and on drug compliance.

Some political ads used in the 2016 U.S. election evoked feelings colloquially known as being moved to tears. We conceptualise this phenomenon as a positive social emotion that appraises and motivates communal relations, is accompanied by physical sensations (including lachrymation, piloerection, chest warmth), and often labelled metaphorically. We surveyed U.S. voters in the fortnight before the 2016 U.S. election. Selected ads evoked the emotion completely and reliably, but in a partisan fashion: Clinton voters were moved to tears by three selected Clinton ads, and Trump voters were moved to tears by two Trump ads. Viewers were much less moved by ads of the candidate they did not support. Being moved to tears predicted intention to vote for the candidate depicted. We conclude that some contemporary political advertising is able to move its audience to tears, and thereby motivates support. This is an Accepted Manuscript of an article published by Taylor & Francis in Cognition and Emotion on 07 Mar 2018, available online: http://www.tandfonline.com/10.1080/02699931.2018.1441128

The Spanish term grima refers to the aversive emotional experience typically evoked when one hears, for example, a scratch upon a chalkboard. Whereas Spanish speakers can distinguish between the concepts of grima and disgust, English and German speakers lack a specific word for this experience and typically label grima as disgust. In the present research, we tested the degree of differentiation between the two aversive experiences in Spanish speakers. Study 1 addressed whether Spanish speakers apply spontaneously the term grima rather than disgust to grima-eliciting experiences. Study 2 systematically addressed the constitutive features of both grima and disgust by mapping their internal structures. Results showed that the noise of a chulk on a blackboard and scraping fingernails on a blackboard, along with the physical manifestation of goose bumps, were the most typical features of the category. Whereas both grima and disgust were characterized as unpleasant sensations, t(193) = 1.21, ns, they differed with respect to their physiological signatures (e.g., producing shivers was characteristic of grima, as compared to disgust, t(194) = 12.02, p = .001, d = 1.72) and elicitors (e.g., a fractured bone was a characteristic elicitor of grima; t(193) = 5.78, p = .001, d = .83, whereas pederasts and pedophiles were the most characteristic elicitor of disgust, t(193) = 8.46, p = .001, d = 1.21). Thus, both grima and disgust are conceptually different experiences, whose shared features hold different degrees of typicality. The present research suggests that grima and disgust are two distinct emotion concepts.

Approximately 40% of women experience excessive hair shedding during styling (e.g., hair brushing). Previously, we demonstrated that topically applied phenylephrine, a potent a1 adrenergic receptor agonist, can be used to contract the arrector pili muscle of the follicular unit ; thus, increasing the force required to pluck hair and reducing shedding during brushing. While demonstrating efficacy, phenylephrine has several drawbacks when applied to the scalp, including the possibility cardiovascular events. We hypothesized that a high concentration of a weak a1 agonist would allow for: (a) rapid penetration through the stratum corneum eliciting a quick response ; (b) a low probability of cardiac adverse events owing to the low receptor binding affinity ; and (c) an efficacy of the weak a1 agonist similar to that of phenylephrine at the local site of application. Accordingly, we developed a novel topical solution, AB-102, containing a high concentration of a weak a1 agonist. Several studies were conducted to test the safety and efficacy of AB-102. In a dose escalating safety study, utilizing a wearable holter monitor, we observed no cardiac or hemodynamic adverse events. In addition, in a controlled efficacy study, AB-102 reduced the number of hairs shed during brushing by up to 77% (average of 38%).

It is a common experience—and well established experimentally—that music can engage us emotionally in a compelling manner. The mechanisms underlying these experiences are receiving increasing scrutiny. However, the extent to which other domains of aesthetic experience can similarly elicit strong emotions is unknown. Using psychophysiology, neuroimaging and behavioral responses, we show that recited poetry can act as a powerful stimulus for eliciting peak emotional responses, including chills and objectively measurable goosebumps that engage the primary reward circuitry. Importantly, while these responses to poetry are largely analogous to those found for music, their neural underpinnings show important differences, specifically with regard to the crucial role of the nucleus accumbens. We also go beyond replicating previous music-related studies by showing that peak aesthetic pleasure can co-occur with physiological markers of negative affect. Finally, the distribution of chills across the trajectory of poems provides insight into compositional principles of poetry.

Purpose Ictal piloerection is an infrequent seizure semiology that is commonly overlooked as an ictal epileptic manifestation. Piloerection is considered to be principally caused by temporal lobe activity although frontal and hypothalamic seizure origins have been reported. The described etiology has shown a wide variety of structural causes such as mesial temporal sclerosis, tumors, posttraumatic, cavernomas and cryptogenic epilepsies. Methods We retrospectively reviewed the incidence of ictal piloerection in the clinical records of patients who underwent video-EEG monitoring (VEEGM) between 2007 and 2013 in a multicenter cooperative study. All patients presented refractory epilepsies and were evaluated with a protocol that included brain MRI, neuropsychology and VEEGM. Results A total of 766 patients were evaluated in four tertiary centers in Spain. Five patients showed piloerection as principal seizure semiology (prevalence 0.65%). The mean age at seizure onset was 39.6 years and the average epilepsy duration was 5.2 years (range 2–14) before diagnosis. Four patients were additionally examined with FDG-PET and/or SPECT-SISCOM. All presented temporal lobe epilepsy (TLE), three right-sided and two left-sided. A typical unilateral hippocampal sclerosis was described in 3 cases. The etiology detected in all cases was limbic encephalitis. Three had LGI1, one anti-Hu, and another Ma2 antibodies. Conclusion Our series describes a so far not well-recognized autoimmune association of pilomotor seizures to limbic encephalitis. This etiology should be ruled out through a comprehensive diagnostic work-up even in cases of long-lasting TLE with typical hippocampal atrophy on MRI.

Feeling moved or touched can be accompanied by tears, goosebumps, and sensations of warmth in the centre of the chest. The experience has been described frequently, but psychological science knows little about it. We propose that labelling one’s feeling as being moved or touched is a component of a social-relational emotion that we term kama muta (its Sanskrit label). We hypothesise that it is caused by appraising an intensification of communal sharing relations. Here, we test this by investigating people’s moment-to-moment reports of feeling moved and touched while watching six short videos. We compare these to six other sets of participants’ moment-to-moment responses watching the same videos: respectively, judgements of closeness (indexing communal sharing), reports of weeping, goosebumps, warmth in the centre of the chest, happiness, and sadness. Our eighth time series is expert ratings of communal sharing. Time series analyses show strong and consistent cross-correlations of feeling moved and touched and closeness with each other and with each of the three physiological variables and expert-rated communal sharing – but distinctiveness from happiness and sadness. These results support our model.

Traction alopecia is hair loss that occurs after persistent pulling (e.g., during cosmetic procedures) on the roots of hair over time. Unlike plucking, which is painful, persistent pulling may go unnoticed until a patient presents with either bald spots or diffuse telogen shedding. Each hair follicle in the scalp contains an arrector pili muscle that, when contracted, erects the hair. The smooth muscle in the arrector pili expresses α1 adrenergic receptors (α1 -AR). As such, we hypothesized that contraction of the arrector pili muscle via an α1 -AR agonist would increase the threshold of force required to pluck hair during cosmetic procedures. Female subjects, ages 18-40, were recruited to study the effect of topically applied phenylephrine, a selective α1 -AR agonist, on epilation force and hair shedding during cosmetic procedures. In our blinded study, 80% of subjects demonstrated reduced shedding on days using phenylephrine compared to days using a placebo solution. The average reduction in hair loss was approximately 42%. In addition, the force threshold required for epilation increased by approximately 172% following topical phenylephrine application. To our knowledge this is the first study demonstrating the utility of α1 -AR agonists in the treatment of traction alopecia and hair shedding during cosmetic procedures.

Research highlights ► Film audio tracks are more powerful than music in eliciting piloerection. ► Objective measurement of piloerection avoids typical biases of self-report measures. ► Piloerection is primarily accompanied by an increase of phasic EDA and respiration depth. ► The separation call hypothesis is favored over the peak arousal hypothesis. ► Emotional piloerection indicates the state of being moved or touched., Piloerection is known as an indicator of strong emotional experiences. However, little is known about the physiological and emotional specificity of this psychophysiological response. In the presented study, piloerection was elicited by audio stimuli taken from music and film episodes. The physiological response accompanying the incidence of piloerection was recorded with respect to electrodermal, cardiovascular and respiratory measures and compared to a matched control condition. The employment of an optical recording system allowed for a direct and objective assessment of visible piloerection. The occurrence of piloerection was primarily accompanied by an increase of phasic electrodermal activity and increased respiration depth as compared to a matched control condition. This physiological response pattern is discussed in the context of dominant theories of human piloerection. Consideration of all available evidence suggests that emotional piloerection represents a valuable indicator of the state of being moved or touched.

Objective Autonomic seizures have been associated with seizure onset in the temporal or insular lobe and consist of variations in blood pressure and heart rate, sweating, flushing, piloerection, hypersalivation, vomiting, spitting, and alterations in bladder and bowel functions. The aim of this study was to evaluate the localizing and lateralizing value of ictal flatulence. Methods Medical records of patients with focal epilepsies who were monitored at the Interdisciplinary Epilepsy Center Marburg between 2006 and 2009 were reviewed for the occurrence of ictal flatulence. Clinical, electrophysiological, and imaging data were reviewed and compared with data for previously reported cases of ictal flatulence. Results Two patients with ictal flatulence were identified (0.6%). In both patients, ictal flatulence was associated with a seizure pattern in the temporal lobe of the dominant hemisphere. Our cases and previously reported cases point toward activation of insular cortex because of such additional autonomic symptoms as unilateral piloerection, tachycardia, profound sweating, and flushing of the face. Conclusions Ictal flatulence is a rare manifestation of autonomic seizures and a localizing sign for temporal or/and insular lobe epilepsies. In general, ictal flatulence seems to have no lateralizing value.

Background Previous studies have shown that a cardiac signature of emotionality (referred to as EK, which can be computed from the standard 12 lead electrocardiogram, ECG), predicts inter-individual differences in the tendency to experience and express positive emotion. Here, we investigated whether EK values can be transiently modulated during stimulation with participant-selected music pieces and film scenes that elicit strongly positive emotion. Methodology/Principal Findings The phenomenon of aesthetic chills, as indicated by measurable piloerection on the forearm, was used to accurately locate moments of peak emotional responses during stimulation. From 58 healthy participants, continuous EK values, heart rate, and respiratory frequency were recorded during stimulation with film scenes and music pieces, and were related to the aesthetic chills. EK values, as well as heart rate, increased significantly during moments of peak positive emotion accompanied by piloerection. Conclusions/Significance These results are the first to provide evidence for an influence of momentary psychological state on a cardiac signature of emotional personality (as reflected in EK values). The possibility to modulate ECG amplitude signatures via stimulation with emotionally significant music pieces and film scenes opens up new perspectives for the use of emotional peak experiences in the therapy of disorders characterized by flattened emotionality, such as depression or schizoid personality disorder.

Autonomic dysfunction in Parkinson's disease (PD) is considered a late complication of the disease or an adverse effect of anti-parkinsonian medications. Morphological changes are demonstrated only by postmortem examination. The study objective was to evaluate peripheral autonomic neural involvement in PD using punch skin biopsy. The study sample included 22 patients (mean age 50 +/- 7.7 years, mean disease duration 5.3 +/- 3.8 years) and 19 controls. Four-millimeter skin biopsies were immunohistochemically stained with anti-PGP 9.5 antibody. Autonomic innervation of the blood vessels, sweat glands, and erector pili muscles was assessed and rated from 0 (normal) to 2 (severe). Cutaneous autonomic innervation was decreased in patients compared to controls. Semi quantitative analysis demonstrated reduced autonomic innervation of the blood vessels (1.0 +/- 0.8 vs. 0.42 +/- 0.8 in controls; p < 0.02), of sweat glands (0.95 +/- 0.67 vs. 0.47 +/- 0.61; p < 0.02) and of the erector pili muscles (1.06 +/- 0.55 vs 0.21 +/- 0.42; p < 0.001). This method demonstrates that the peripheral autonomic system is affected in PD at early stage of the disease and that autonomic involvement in PD may be more prevalent than previously thought.

We report pilomotor seizures in two patients who presented with piloerection or gooseflesh spreading in a pattern similar to the ‘Jacksonian march'. Gooseflesh was confined to the ipsilateral side in most of the episodes. Occasionally it spread to the contralateral side. It was also associated with other autonomic symptoms and complex partial features of temporal lobe origin. Simple partial status that progressed to complex partial status occurred in the second patient. Very rarely secondary generalization occurred. The cause was left sphenoid meningioma and temporal tip contusion in the first case. It was idiopathic in the second case, although a positive family history of complex partial seizures was obtained in this patient. Interictal electroencephalogram (EEG) showed left temporal focus in the first and bitemporal foci with right fronto-temporal dominance in the second. Parenteral phenytoin controlled the partial complex status in the second and carbamazepine controlled the episodes in both cases. To our knowledge all reported cases were symptomatic and our case of idiopathic aetiology is the first to be recorded. We endorse that pilomotor seizures are autonomic in nature and constitute a subtype of simple partial seizures. These autonomic simple partial seizures may progress to, or be a component of, complex partial seizures of temporal lobe origin. Based on their dominance in such a symptom complex and careful interpretation of the ictal history, it can be logically concluded that pilomotor seizures may be underestimated by both patients and physicians.

Laetia suaveolens, known as “casinga-cheirosa”, crude extract EB719 has previously shown cytotoxic activity against prostate cancer and squamous cell carcinoma. For the first time, seven molecules were isolated from its apolar—α-tocopherol (1) and sitosterol (2)—and polar—3-O-caffeoylquinic acid (3), 4-O-caffeoylquinic acid (4), 5-O-feruloylquinic acid (5), hyperoside (6), and isoquercitrin (7)—fractions. Acute toxicity was determined in a two-stage experiment: (1) a reduced number of Balb-c male mice received 5000 mg/kg of EB719 to allow evaluation of general activity and other 27 parameters, plus death, up to the establishment of non-lethal dose (NLD), as well as lethal dose 50% (LD50); (2) NLD was administered and diazepam introduced as reference drug. EB719 showed LD50 = 178.0 mg/kg, and NLD 156.3 mg/kg. In stage one EB719 did not influence general activity, but provoked impairment in grasp reflexes, tail squeeze and breathing; piloerection and cyanosis were increased. In stage two, alterations occurred in auricular reflex, piloerection and breathing after diazepam administration, but not in response to EB719. Intestinal hemorrhage caused by local bleeding was observed after necropsy, and may be the main cause of animals’ death other than a systemic effect of the extract. Although the isolated compounds are biologically and pharmacologically active in both men and animal systems, it is premature to relate their occurrence in EB719 to the observed intestine hemorrhage in mice.

'Goose-bumps' seizures are rare manifestations of epilepsy. They are rarely reported by patients and can be easily dismissed by clinicians. Clinically, it carries some diagnostic localising value especially with unilateral onset. In this report, we present a case of intraventricular glioblastoma multiforme with ipsilateral goose bumps and review the literature.

A 26 year old female with right mesial temporal sclerosis presented with events characterized by repetitive piloerection (goose bumps). These events were monitored using prolonged video-EEG. The events occurred at a rate of one per every 15 min, and were demonstrated to be simple partial seizures of right mesial temporal origin. The manifestations included piloerection, cold shivers and ictal tachycardia. These were effectively treated with lorazepam. Acute repetitive pilomotor seizures are rare. This is the first reported case with right mesial temporal sclerosis.

A 68-year-old man complained of acute and recurrent episodes of diffuse gooseflesh variably accompanied by nonfluent aphasia, emotional distress, and focal myoclonic jerks (video 1 on the Neurology ® Web site at www.neurology.org), lasting about 2 minutes and occurring up to every 15 minutes. Contemporaneous EEG recording showed epileptic discharges over left temporal derivations (video 2). MRI showed a left temporal mass extending from the temporal pole to …

Piloerection is a rare ictal manifestation usually associated with temporal lobe epilepsy. We present video and electrographic documentation of pilomotor seizures in a 75-year-old man with left temporal lobe epilepsy and remote herpes zoster encephalitis. In general, piloerection is most often localised to the temporal lobe. Unilateral piloerection is usually associated with an ipsilateral ictal onset. Bilateral piloerection has a less certain lateralising value, although earlier reports suggest left hemispheric predominance [Published with videosequences].

Objective To report piloerection and vasomotor instability as a sole manifestation of partial seizures. Design Case report. Setting Inpatient tertiary care center. Patient A 72-year-old man with acute onset of repetitive autonomic events. Main Outcome Measures Extensive cardiovascular evaluation, electroencephalographic testing, radiology, laboratory assessment, and frequency of clinical events (seizures). Results We characterize an uncommon manifestation of right temporal lobe partial seizures, initially thought to be cardiovascular in origin, as pilomotor seizures accompanied by other autonomic phenomena. The ictal electroencephalogram recordings established the diagnosis of right temporal lobe seizures, and head magnetic resonance imaging demonstrated right mesial temporal T2 signal change, enhancement, and subsequent atrophy. The underlying etiology was not uncovered despite an extensive laboratory and radiological evaluation. However, given the history and imaging findings, an infectious or secondary immunological etiology was suspected. Conclusions Pilomotor events with other transient autonomic features, such as tachycardia and blood pressure fluctuations, may represent localization-related epilepsy. The acute onset of these events accompanied by other autonomic phenomena in the setting of focal magnetic resonance imaging abnormalities within the hippocampal region raises questions concerning pilomotor seizures as well as the differential diagnosis of acute seizure activity in the setting of neuroimaging findings characteristic for limbic encephalitis.

Objective Pilomotor seizure (PS) is a rare subtype of simple and complex partial seizures, often related to temporal lobe epilepsy and occasionally linked to alterations of amygdala. The physiologic role played by this latter region in the coordination of autonomic responses to fear-induced emotional changes raises the question as to whether the involvement of amygdala in PS might elicit a disconnection between subjective symptoms and neurovegetative signs. Methods We report a case of idiopathic bilateral PS studied with video electroencephalogram, polygraphic 24-hour Holter electroencephalogram, and magnetic resonance imaging, plus spectral functional magnetic resonance imaging, in which the seizures were associated with abrupt tachycardia occurring in a state of emotional neutrality, without either clouding or loss of consciousness. Results Electroencephalogram documented PS episodes occurring during waking, rapid eyes movements, and nonrapid eye movement sleep stages. Although no morphologic alteration was detected, spectral magnetic resonance imaging visualized alterations of the metabolic ratios of N-acetylaspartate and creatine-phosphocreatine in hippocampus and amygdala, whereas no apparent involvement of the temporal lobe was found. Conclusions These findings suggest that the limited involvement of amygdala and hippocampus in PS triggers the repertoire of fear-related sympathetic responses uncoupled from alterations in emotional status. This phenomenon supports the possibility that autonomic responses involved in fear or extreme alertness follow a kind of "ethological" modularity.

Patients with seizures occasionally present with autonomic symptoms. Pilomotor seizures are uncommon and usually accompanied by other manifestations of complex partial seizures of limbic origin. Activation of the central autonomic network appears to be necessary for the development of ictal goose bumps. Pilomotor seizures have been reported to originate in the temporal lobe and other medial limbic structures. Ictal piloerection can arise due to a variety of brain pathologies. Isolated pilomotor seizures are very rare. The authors present the first case in which intracranial electroencephalography monitoring was used to confirm pilomotor seizures of temporal neocortical origin in association with an infiltrating tumor.

Increasing attention is drawn to the investigation of piloerection (or goose bumps) in response to strong emotional experiences. This research is complicated by the need to rely on self-report measures. This article proposes an efficient method for the objective and continuous measurement of piloerection. It is based on an optical recording device combined with a discrete Fourier transform analysis quantifying the frequency power related to visible piloerection. The validity of the method was demonstrated in a proof-of-principle experiment involving a person with the exceptional ability to control the erection of his hair. The method reliably mapped all occurrences of visible piloerection and provided insight into the temporal dynamics of the underlying physiological process. It thus proved suitable for future experimental investigation of human piloerection. Descriptors: Piloerection, Goose bumps, Chills, Discrete Fourier transform

Percutaneous nicotine administration induces predominant sudorific and rubiform responses in the skin which may be accompanied by subtle piloerection, hyperalgesia and pruritus (although these signs are not overtly manifest). These dermal responses are complex and mechanisms have been proposed for the direct nicotine-stimulation of sweat glands, piloerection and vasoconstriction. These reactions are accompanied by secondary activation and release of vasodilator peptides which produce a predominating vasodilator tone following topical administration, this response masking the direct axon reflex-mediated vasoconstriction.

When a dobutamine stress echocardiogram is performed, piloerection is frequently found in the scalp area.The aim of the present study was to establish the incidence of this phenomenon and its association with other clinical findings.A total of 218 consecutive patients that underwent dobutamine stress echocardiography in our department were included in the study.Piloerection was present in 42.2% of the sample. No correlations could be established between piloerection and gender, result of the stress test or other side effects. A statistically significant correlation was established with the age of the patients: piloerection was present in 73% of patients aged 50 years or younger. It appears most often with a dobutamine dose of 10 microg/kg/min.Piloerection is a frequent side effect of dobutamine infusion, particularly in patients aged 50 or less; it usually precedes the increase in heart rate caused by dobutamine; therefore, it is an early and clear indication that the intravenous set is working properly. Also, the previous warning of its possible appearance may contribute to the patient's well-being.

We report a 50-year-old man that presented a zosteriform cutaneous leiomyoma in the left facial region, intensely painful, that showed great improvement after the administration of a daily dose of 4 mg of oral doxasozin. The therapy was well tolerated and did not present any associated adverse effect. In the English medical literature only two cases successfully treated with doxasozin have been reported.

Aims To present a case of piloerection after replacing fluvoxamine maleate with milnacipran hydrochloride, and to analyse this effect based on receptor occupancy theory. Methods A 40-year-old female with a 3-year history of panic disorder was prescribed fluvoxamine 50 mg day−1 in addition to clorazepate dipotassium and sulpiride. Depression was not improved and she complained of fatigue, lack of energy and drowsiness. These symptoms worsened within a few days of an increase in the dose of fluvoxamine to 50 mg twice daily. Since an interaction between fluvoxamine and tizanidine, prescribed by another clinic, was suspected, fluvoxamine was replaced with milnacipran 50 mg day−1. Although her drowsiness improved, she complained of piloerection throughout her body. This symptom gradually abated within a week and when the dosage of milnacipran was increased to 100 mg day−1 at 2 months, no further piloerection occurred. We calculated the changes in α1-adrenoceptor occupancy by endogenous norepinephrine during treatment with the usual doses of milnacipran, fluvoxamine and imipramine by using pharmacokinetic and pharmacodynamic parameters obtained from the literature. Results The ratios of α1-adrenoceptor occupancy by endogenous norepinephrine during the treatment with milnacipran, fluvoxamine and imipramine to that without drug were estimated to be 7.13, 1.00 and 4.12, respectively. The α1-adrenoceptor occupancy by endogenous norepinephrine was increased in a dose-dependent manner by milnacipran, whereas fluvoxamine had essentially no effect. Conclusions The piloerection observed after the replacement of fluvoxamine with milnacipran in this patient appears to have been due to an increase in the α1-adrenoceptor occupancy by endogenous norepinephrine induced by milnacipran.

We report pilomotor seizures in two patients who had piloerection or gooseflesh spreading in a pattern like the ‘Jacksonian march’, confined ipsilaterally to the lesion side. The first patient presented this in conjunction with complex partial seizures. Left anterior temporal lobectomy abolished pilomotor and other seizures. Pathological study demonstrated hippocampal sclerosis. A meningioma near the left sphenoid region, incompletely removed, is the likely cause of pilomotor seizures in the second patient. Carbamazepine reduced these attacks. To our knowledge, hippocampal sclerosis and meningioma have never been linked to pilomotor seizures.

Piloerection is rarely described in seizures. This symptom has been most frequently observed in patients with temporal lobe epilepsy and is rarely the principal clinical feature of seizures. No specific etiology of epilepsy associated with pilomotor seizures has been reported. We present the first case of a patient who experienced sudden and transitory epilepsy with pilomotor seizures occurring several times a day for months, and associated with sequential changes of the left hippocampus demonstrated by magnetic resonance imaging. [Published with video sequences].

To describe an unusual clinical presentation of a patient with voltage-gated potassium channel Ab- positive, non-paraneoplastic limbic encephalitis.We performed video-EEG monitoring, structural MRI, (18)F-FDG-PET, (1)H-MRS, neuropsychological testing and antibody serology.A 42-year-old male patient presented in an acute phase of non-paraneoplastic limbic encephalitis confirmed by MRI, with antibodies to voltage-gated potassium channels. His pilomotor status was pharmacoresistant to antiepileptic drugs, but responded to corticosteroid and azathioprine treatment. The MRI findings improved. The pilomotor seizures recurred when the immunosuppressive therapy was discontinued after 18 months. MRI at that time was consistent with hippocampal sclerosis. Complete seizure control was achieved after reintroduction of steroids.Pilomotor seizures were the predominant seizure type in this case of non-paraneoplastic limbic encephalitis. Immunosuppressive therapy may provide recovery including seizure control. However, long-term immunosuppression may be necessary to prevent relapse. Hippocampal sclerosis and chronic epilepsy might evolve as sequelae of limbic encephalitis.

Background: Piloerection is a rare clinical symptom described during seizures. Previous reports suggested that the temporal lobe is the ictal onset zone in many of these cases. One case series concluded that there is a predominant left hemispheric representation of ictal cold. The aim of this study is to evaluate the localising and lateralising value of pilomotor seizures. Methods: Medical records of patients who underwent video electroencephalogram (EEG) monitoring at the Cleveland Clinic between 1994 and 2001 were reviewed for the presence of ictal piloerection. The clinical history, physical and neurological examination, video EEG data, neuroimaging data, cortical stimulation results, and postoperative follow ups were reviewed and used to define the epileptogenic zone. Additionally, all previously reported cases of ictal piloerection were reviewed. Results: Fourteen patients with ictal piloerection were identified (0.4%). Twelve out of 14 patients had temporal lobe epilepsy. In seven patients (50%), the ictal onset was located in the left hemisphere. Four out of five patients with unilateral ictal piloerection had ipsilateral temporal lobe epilepsy as compared with the ipsilateral side of pilomotor response. Three patients became seizure free after left temporal lobectomy for at least 12 months of follow up. An ipsilateral left leg pilomotor response with simultaneously recorded after-discharges was elicited in one patient during direct cortical stimulation of the left parahippocampal gyrus. Conclusions: Ictal piloerection is a rare ictal manifestation that occurs predominantly in patients with temporal lobe epilepsy. Unilateral piloerection is most frequently associated with ipsilateral focal epilepsy. No hemispheric predominance was found in patients with bilateral ictal piloerection.

Cold shiver and piloerection are rare ictal signs in focal epilepsies. They are often associated with an epileptic seizure focus within the temporal lobe. In rare cases the phenomenon of piloerection has been reported to be confined to body parts ipsilateral to the seizure focus. In this multicentric study epilepsy patients with ictal cold shiver and/or piloerection were retrospectively asked to describe exactly location and spreading patterns of these signs as well as their temporal sequence in relation to other ictal signs. Clinical data, etiology of epilepsy, and seizure focus location were also assessed. In our patient group there was a high relationship to an epileptic focus within the left temporal lobe. Distinct spreading patterns or unilateral piloerection was not indicative of a focus in the ipsilateral temporal lobe as described previously. Our results suggest that phenomena of temperature dysregulation during epileptic seizures may be of value in the presurgical evaluation as they may be indicative of a left temporal lobe seizure focus.

Goose flesh and cold shiver can be ictal signs of visceral epilepsies. These visceral epilepsies may occur with isolated ictal signs during a simple partial seizure or in combination with other autonomic signs or in complex partial seizures. Because of the unusual features of the ictal symptomatology, these visceral epilepsies often are masked and wrongly diagnosed as nonepileptic events, e.g., somatoform disorders. Five cases are reported with case history, neurological findings, and results of electroencephalography, MEG, and imaging. Interestingly, patients did not suffer from tumoral epilepsies and the epileptic focus was lateralized to the left (dominant) temporal lobe.

This man's episodes of unilateral sweating (figure 1), flushing and piloerection started after heavy physical work moving 20 tons of gravel. Harlequin syndrome may be due to an underlying defect in the region of the thoracic sympathetic outflow as discussed in the literature. Sudomotor and …

Dopamine causes reflex erythema, central blanching, and piloerection depending on the dose and the type of application wheal reaction. Intracutaneous application shows from 1.5 gamma/0.1 ml wheal formation, erythema, piloerection, and blanching combined with increased heat radiation from the skin surface (AGA thermovision). Epicutaneous application from 500 ml (occlusive patch test) following horny layer stripping, causes marked blanching with weak piloerection. Iontophoretic application of dopamine 1/1,000 (60 s, 0.5 mA) causes only blanching and weak surrounding erythema; application of dopamine 1/100 additionally causes piloerection. This application shows no changing of infrared radiation. Iontophoretic application of dopamine 1/100 or 50 gamma/0.1 ml i.c. in a blanched area after locally applied corticosteroids (McKenzie test) shows diminution of infrared radiation proved by AGA thermovision thermography. Antihistaminics, applied externally, decrease reddening, wheal development as well as blanching by dopamine. Guanethedine (1% in eucerin) increases the blanching phenomenon (false transmitter effect of dopamine). Phentolamine 1% in W/O emulsion is without effect on dopamine reaction. Caffeine ointment (4%) reduces erythema and accentuates the degree of blanching. Oral haloperidol has no influence on the dopamine skin reaction, but increases the blanching in areas of antihistamine treatment. Skin veins and varices show marked vasoconstriction within 10 min after iontophoretic (1 : 100, 3.5 mA, 60 s) or i.c. application (50 gamma/0.2 ml).

Attack behaviors of dominant colony males of established albino rat colonies, on intruders, were measured following septal lesions or control operations. Septal damage produced a significant decrease in piloerection, biting, and lateral attack behaviors, as well as in the number of wounds observed on the intruders. These differences tended to disappear during a 3-week period after surgery. Thus septal damage in the rat as well as the mouse appears to produce a systematic reduction in aggressive attack behaviors.