Lateralizing value of postictal automatisms in temporal lobe epilepsy

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Abstract

Purpose: To describe clinical characteristics and lateralizing value of postictal automatisms in patients with temporal lobe epilepsy (TLE). Methods: One hundred and ninety-three videotaped seizures of 55 consecutive patients with refractory TLE and postoperatively seizure-free outcome were analyzed. Ictal as well as postictal (manual, oral and speech) automatisms were monitored. Results: Thirty-four (62%) of the 55 patients showed PA at least once during their seizures. Postictal automatism was observed in 70 (36%) attacks as manual (21%), oral (13%) or speech (9%) automatisms. Fifteen seizures contained a combination of two different postictal automatisms. The presence of postictal oral automatisms did not lateralize the seizure onset zone (p = 0.834). Speech automatisms (repetitive verbal behavior) occurred more frequently after left-sided seizures (p = 0.002). Postictal unilateral manual automatism showed no lateralizing value occurring by the ipsilateral hand in 10 and the contralateral upper limb in 6 seizures (p = 0.454). Conclusion: : Postictal automatism is a relatively frequent phenomenon in TLE. Postictal speech automatism lateralizes the seizure onset zone to the left hemisphere. Our observation can help the presurgical evaluation of TLE because verbal perseveration frequently occurs spontaneously, even in seizures without appropriate postictal language testing.

Original languageEnglish
Pages (from-to)239-243
Number of pages5
JournalEpilepsy Research
Volume70
Issue number2-3
DOIs
Publication statusPublished - aug. 2006

Fingerprint

Automatism
Temporal Lobe Epilepsy
Seizures
Verbal Behavior
Upper Extremity
Language
Hand
Stroke
Observation

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Neurology

Cite this

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abstract = "Purpose: To describe clinical characteristics and lateralizing value of postictal automatisms in patients with temporal lobe epilepsy (TLE). Methods: One hundred and ninety-three videotaped seizures of 55 consecutive patients with refractory TLE and postoperatively seizure-free outcome were analyzed. Ictal as well as postictal (manual, oral and speech) automatisms were monitored. Results: Thirty-four (62{\%}) of the 55 patients showed PA at least once during their seizures. Postictal automatism was observed in 70 (36{\%}) attacks as manual (21{\%}), oral (13{\%}) or speech (9{\%}) automatisms. Fifteen seizures contained a combination of two different postictal automatisms. The presence of postictal oral automatisms did not lateralize the seizure onset zone (p = 0.834). Speech automatisms (repetitive verbal behavior) occurred more frequently after left-sided seizures (p = 0.002). Postictal unilateral manual automatism showed no lateralizing value occurring by the ipsilateral hand in 10 and the contralateral upper limb in 6 seizures (p = 0.454). Conclusion: : Postictal automatism is a relatively frequent phenomenon in TLE. Postictal speech automatism lateralizes the seizure onset zone to the left hemisphere. Our observation can help the presurgical evaluation of TLE because verbal perseveration frequently occurs spontaneously, even in seizures without appropriate postictal language testing.",
keywords = "Aphasia, Lateralizing signs, Oral and manual automatism, Perseveration, Temporal lobe epilepsy",
author = "G. R{\'a}sonyi and A. Fogarasi and A. Kelemen and J. Janszky and P. Hal{\'a}sz",
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T1 - Lateralizing value of postictal automatisms in temporal lobe epilepsy

AU - Rásonyi, G.

AU - Fogarasi, A.

AU - Kelemen, A.

AU - Janszky, J.

AU - Halász, P.

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N2 - Purpose: To describe clinical characteristics and lateralizing value of postictal automatisms in patients with temporal lobe epilepsy (TLE). Methods: One hundred and ninety-three videotaped seizures of 55 consecutive patients with refractory TLE and postoperatively seizure-free outcome were analyzed. Ictal as well as postictal (manual, oral and speech) automatisms were monitored. Results: Thirty-four (62%) of the 55 patients showed PA at least once during their seizures. Postictal automatism was observed in 70 (36%) attacks as manual (21%), oral (13%) or speech (9%) automatisms. Fifteen seizures contained a combination of two different postictal automatisms. The presence of postictal oral automatisms did not lateralize the seizure onset zone (p = 0.834). Speech automatisms (repetitive verbal behavior) occurred more frequently after left-sided seizures (p = 0.002). Postictal unilateral manual automatism showed no lateralizing value occurring by the ipsilateral hand in 10 and the contralateral upper limb in 6 seizures (p = 0.454). Conclusion: : Postictal automatism is a relatively frequent phenomenon in TLE. Postictal speech automatism lateralizes the seizure onset zone to the left hemisphere. Our observation can help the presurgical evaluation of TLE because verbal perseveration frequently occurs spontaneously, even in seizures without appropriate postictal language testing.

AB - Purpose: To describe clinical characteristics and lateralizing value of postictal automatisms in patients with temporal lobe epilepsy (TLE). Methods: One hundred and ninety-three videotaped seizures of 55 consecutive patients with refractory TLE and postoperatively seizure-free outcome were analyzed. Ictal as well as postictal (manual, oral and speech) automatisms were monitored. Results: Thirty-four (62%) of the 55 patients showed PA at least once during their seizures. Postictal automatism was observed in 70 (36%) attacks as manual (21%), oral (13%) or speech (9%) automatisms. Fifteen seizures contained a combination of two different postictal automatisms. The presence of postictal oral automatisms did not lateralize the seizure onset zone (p = 0.834). Speech automatisms (repetitive verbal behavior) occurred more frequently after left-sided seizures (p = 0.002). Postictal unilateral manual automatism showed no lateralizing value occurring by the ipsilateral hand in 10 and the contralateral upper limb in 6 seizures (p = 0.454). Conclusion: : Postictal automatism is a relatively frequent phenomenon in TLE. Postictal speech automatism lateralizes the seizure onset zone to the left hemisphere. Our observation can help the presurgical evaluation of TLE because verbal perseveration frequently occurs spontaneously, even in seizures without appropriate postictal language testing.

KW - Aphasia

KW - Lateralizing signs

KW - Oral and manual automatism

KW - Perseveration

KW - Temporal lobe epilepsy

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