Lateralizing Value of Asymmetric Tonic Limb Posturing Observed in Secondarily Generalized Tonic–Clonic Seizures

Summary: Purpose: A striking asymmetry of limb posture occurs during secondarily generalized tonic–clonic (GTC) seizures wherein one elbow is extended while the other is flexed during the tonic phase of the GTC seizure. We have named this phenomenon asymmetric tonic limb posturing (ATLP) or the “Figure 4 Sign.”