Letter to the Editor
Sweating as a presentation of focal epilepsy: clinical case report
Sudoración como presentación de epilepsia focal: descripción de un caso clínico
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López-Bravo, A.A. Sanabria-Sanchinel, M. Marín-Gracia, A. Viloria-Alebesque" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "López-Bravo" "email" => array:1 [ 0 => "alba.lopez.bravo@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A.A." "apellidos" => "Sanabria-Sanchinel" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Marín-Gracia" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "Viloria-Alebesque" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Departamento de Neurología, Hospital Reina Sofía, Tudela, Navarra, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Instituto de Investigación Sanitaria de Aragón (IIS-A), Zaragoza, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Neurología, Hospital Clínico Lozano Blesa, Zaragoza, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Neurología, Hospital General de Defensa, Zaragoza, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sudoración como presentación de epilepsia focal: descripción de un caso clínico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1422 "Ancho" => 1583 "Tamanyo" => 186775 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sweating in the patient's right lower limb during an epileptic seizure.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Autonomic symptoms may be the first manifestation of an epileptic seizure.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The International League Against Epilepsy (ILAE) classification identifies autonomic seizures as focal non-motor seizures.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Autonomic symptoms may range from subclinical changes to potentially fatal haemodynamic instability. The anatomical substrate of autonomic seizures generally resides in the central autonomic network. This network comprises the insular cortex, anterior cingulate cortex, amygdalae, hypothalamus, periaqueductal grey matter, parabrachial nucleus, solitary nucleus, rostral ventrolateral medulla, and raphe nucleus.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> We present the case of a patient with episodes of right hemibody hyperhidrosis secondary to insular dysplasia.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was a 39-year-old right-handed man with no relevant medical history. From the age of 28, he had presented episodes of increased temperature and sweating on the right side of the face and body; episodes lasted 5-10<span class="elsevierStyleHsp" style=""></span>minutes and did not involve altered level of consciousness (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> and <a class="elsevierStyleCrossRef" href="#sec0015">Appendix B</a>). These episodes presented 6-7 times per day. The baseline sleep-deprived electroencephalogram (EEG) showed no epileptiform alterations. A brain magnetic resonance imaging (MRI) study (3T scanner) revealed radiological signs suggestive of polymicrogyria of the left insular cortex (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Suspecting focal autonomic seizures, we started treatment with eslicarbazepine acetate at 800<span class="elsevierStyleHsp" style=""></span>mg/day; this reduced the number of seizures to the current frequency of one episode per month. Dosage is currently being adjusted; no video EEG monitoring has been performed due to a lack of availability at our centre and the good response to treatment.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Autonomic symptoms frequently present during seizures, either as the predominant manifestation or in association with other convulsive symptoms. They may be classified as cardiovascular changes, and respiratory, gastrointestinal, skin, pupillary, genitourinary, or sexual manifestations.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> Some of these signs and symptoms may help us to locate and lateralise the area of seizure onset and the subsequent route of propagation. They may also assist in understanding the anatomical and functional organisation of the central autonomic network.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Previously described cutaneous manifestations include flushing, pallor, sweating, and piloerection. Autonomic symptoms have been attributed to different aetiologies: Franco et al.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> reported a patient with ipsilateral facial sweating secondary to anti-Ma2 autoimmune encephalitis associated with testicular teratoma. Sweating in the context of seizures has also been reported in a patient with a basal forebrain malformation, in association with tremor and hypothermia.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Cases have also been reported of generalised sweating with other vegetative symptoms, with one case secondary to a periventricular lesion extending to the limbic area,<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> and another as a consequence of a parietal meningioma.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Previous cases have also been reported of episodes of hyperhidrosis and ictal piloerection of autoimmune origin in the temporal lobe. Other structures participating in the central autonomic network have less frequently been associated with pilomotor seizures.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> We present the first case of seizures presenting with hyperhidrosis and no piloerection, contralateral to insular polymicrogyria. Insular epilepsy is difficult to diagnose due to its clinical heterogeneity: with the exception of nociceptive symptoms, no clinical presentation is very specific of this location; autonomic symptoms have been described in this clinical entity.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> On many occasions, conventional EEG does not reveal alterations due to the deep location of the insula, which makes it necessary to perform video EEG monitoring in the event of treatment resistance.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> In our patient, the purely autonomic clinical presentation led us to consider the insula as a possible site of seizure onset, given its role in the central autonomic network; while non-specific, the absence of pathological data on the EEG may be compatible with alterations in this location, and the detection of a structural alteration in the MRI study together with the good response to antiepileptic drugs make us consider this diagnosis probable. One limitation of this study is the lack of video EEG monitoring or stereo EEG, which may help establish a more accurate electro-clinical correlate.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion, we present a case of autonomic seizures with hyperhidrosis probably caused by contralateral insular polymicrogyria. We consider it important to systematically describe more patients with infrequent autonomic symptoms, such as sweating, in order to establish the potential of these symptoms to locate and lateralise lesions.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have received no external funding for this study.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "⋆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: López-Bravo A, Sanabria-Sanchinel AA, Marín-Gracia M, Viloria-Alebesque A. Sudoración como presentación de epilepsia focal: descripción de un caso clínico. Neurología. 2021;36:332–334.</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0045" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0015" ] ] ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1422 "Ancho" => 1583 "Tamanyo" => 186775 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sweating in the patient's right lower limb during an epileptic seizure.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1395 "Ancho" => 1583 "Tamanyo" => 192759 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">T2-weighted brain MRI sequence (coronal plane) showing prominence of the left Sylvian fissure and polymicrogyria of the left insular cortex.</p>" ] ] 2 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 6294714 "Video" => array:2 [ "mp4" => array:5 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autonomic epilepsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Freeman" 1 => "S.C. Schachter" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-2008-1041019" "Revista" => array:6 [ "tituloSerie" => "Semin Neurol" "fecha" => "1995" "volumen" => "15" "paginaInicial" => "158" "paginaFinal" => "166" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7481135" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE Commission for classification and terminology" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.S. Fisher" 1 => "J.H. Cross" 2 => "J.A. French" 3 => "N. Higurashi" 4 => "E. Hirsch" 5 => "F.E. Jansen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/epi.13670" "Revista" => array:6 [ "tituloSerie" => "Epilepsia" "fecha" => "2017" "volumen" => "58" "paginaInicial" => "522" "paginaFinal" => "530" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28276060" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Central control of autonomic function and involvement in neurodegenerative disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.G. Cersosimo" 1 => "E.E. Benarroch" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/B978-0-444-53491-0.00005-5" "Revista" => array:6 [ "tituloSerie" => "Handb Clin Neurol" "fecha" => "2013" "volumen" => "117" "paginaInicial" => "45" "paginaFinal" => "57" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24095115" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology and pathophysiology of autonomic seizures: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Baumgartner" 1 => "J. Koren" 2 => "M. Britto-Arias" 3 => "S. Schmidt" 4 => "S. Pirker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10286-019-00596-x" "Revista" => array:6 [ "tituloSerie" => "Clin Auton Res" "fecha" => "2019" "volumen" => "29" "paginaInicial" => "137" "paginaFinal" => "150" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30805869" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ictal ipsilateral sweating in focal epilepsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.C. Franco" 1 => "S. Noachtar" 2 => "J. Rémi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.seizure.2017.05.009" "Revista" => array:6 [ "tituloSerie" => "Seizure" "fecha" => "2017" "volumen" => "50" "paginaInicial" => "4" "paginaFinal" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28558270" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Basal forebrain malformation with hyperhidrosis and hypothermia: variant of Shapiro's syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.J. Klein" 1 => "M.H. Silber" 2 => "J.R. Halliwill" 3 => "S.A. Schreiner" 4 => "G.A. Suarez" 5 => "P.A. Low" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1212/wnl.56.2.254" "Revista" => array:6 [ "tituloSerie" => "Neurology" "fecha" => "2001" "volumen" => "56" "paginaInicial" => "254" "paginaFinal" => "256" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11160966" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "[Partial simple vegetative crisis: importance of electroencephalographic findings]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "V. Cortés" 1 => "L. Landete" 2 => "E. Gómez" 3 => "R. Blasco" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Neurol" "fecha" => "1997" "volumen" => "25" "paginaInicial" => "1931" "paginaFinal" => "1933" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9528034" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of digestive epilepsy with late diagnosis: a disease not to be disregarded" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.H. Mendler" 1 => "D. Sautereau" 2 => "B. Pillegand" 3 => "R. Ravon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Gastroenterol Clin Biol" "fecha" => "1998" "volumen" => "22" "paginaInicial" => "235" "paginaFinal" => "239" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9762197" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pilomotor seizures: an autonomic semiology of limbic encephalitis?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Rocamora" 1 => "J.L. Becerra" 2 => "P. Fossas" 3 => "M. Gomez" 4 => "R.M. Vivanco-Hidalgo" 5 => "J.A. Mauri" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.seizure.2014.04.013" "Revista" => array:6 [ "tituloSerie" => "Seizure" "fecha" => "2014" "volumen" => "23" "paginaInicial" => "670" "paginaFinal" => "673" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24890932" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The insula and its epilepsies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.C. Jobst" 1 => "J. Gonzalez-Martinez" 2 => "J. Isnard" 3 => "P. Kahane" 4 => "N. Lacuey" 5 => "S.D. Lahtoo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/1535759718822847" "Revista" => array:7 [ "tituloSerie" => "Epilepsy Curr" "fecha" => "2019" "volumen" => "19" "paginaInicial" => "11" "paginaFinal" => "21" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30838920" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1386505617301600" "estado" => "S300" "issn" => "13865056" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735808/0000003600000004/v1_202105110731/S2173580821000316/v1_202105110731/en/main.assets" "Apartado" => array:4 [ "identificador" => "9409" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735808/0000003600000004/v1_202105110731/S2173580821000316/v1_202105110731/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580821000316?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 55 | 2 | 57 |
| 2024 October | 290 | 11 | 301 |
| 2024 September | 291 | 15 | 306 |
| 2024 August | 315 | 11 | 326 |
| 2024 July | 408 | 13 | 421 |
| 2024 June | 269 | 19 | 288 |
| 2024 May | 355 | 14 | 369 |
| 2024 April | 366 | 11 | 377 |
| 2024 March | 485 | 8 | 493 |
| 2024 February | 439 | 7 | 446 |
| 2024 January | 510 | 10 | 520 |
| 2023 December | 652 | 12 | 664 |
| 2023 November | 421 | 26 | 447 |
| 2023 October | 503 | 23 | 526 |
| 2023 September | 385 | 22 | 407 |
| 2023 August | 355 | 1 | 356 |
| 2023 July | 379 | 23 | 402 |
| 2023 June | 336 | 21 | 357 |
| 2023 May | 396 | 11 | 407 |
| 2023 April | 358 | 8 | 366 |
| 2023 March | 525 | 14 | 539 |
| 2023 February | 225 | 8 | 233 |
| 2023 January | 192 | 6 | 198 |
| 2022 December | 147 | 6 | 153 |
| 2022 November | 282 | 8 | 290 |
| 2022 October | 279 | 14 | 293 |
| 2022 September | 282 | 15 | 297 |
| 2022 August | 231 | 17 | 248 |
| 2022 July | 178 | 11 | 189 |
| 2022 June | 130 | 13 | 143 |
| 2022 May | 108 | 11 | 119 |
| 2022 April | 113 | 7 | 120 |
| 2022 March | 129 | 4 | 133 |
| 2022 February | 104 | 6 | 110 |
| 2022 January | 112 | 11 | 123 |
| 2021 December | 84 | 11 | 95 |
| 2021 November | 84 | 9 | 93 |
| 2021 October | 100 | 14 | 114 |
| 2021 September | 72 | 13 | 85 |
| 2021 August | 57 | 21 | 78 |
| 2021 July | 36 | 15 | 51 |
| 2021 June | 35 | 10 | 45 |
| 2021 May | 36 | 8 | 44 |
| 2021 April | 8 | 19 | 27 |
| 2021 March | 1 | 14 | 15 |
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