Lateralizing value of unilateral motor and somatosensory manifestations in frontal lobe seizures

J. Janszky, A. Fogarasi, H. Jokeit, A. Ebner

Research output: Article

45 Citations (Scopus)

Abstract

Purpose: To evaluate the lateralizing value of unilateral somatosensory aura, unilateral tonic posturing, head version, non-forced head turning, ictal cloni, dystonic posturing, and postictal nose wiping in seizures originating in the frontal lobe. Methods: We included patients who had consecutively undergone presurgical evaluation with ictal video-EEG monitoring at our institution, had had resective epilepsy surgery involving the frontal lobe, and had remained seizure-free >1 year after operation. Twenty-seven patients aged 1-42 years (mean 18) met the inclusion criteria. Fifteen patients had right-sided, 12 patients had left-sided epileptogenic regions. Seizures recorded during EEG-video monitoring were re-evaluated by two investigators in order to identify lateralization signs in frontal lobe seizures. One of the investigators was blind to patients' clinical data. Results: We analyzed 153 seizures of 27 patients. The most common unilateral phenomenon was the unilateral tonic posturing occurring in 48% of all the patients and in 25% of all seizures. Somatosensory aura and head version appeared exclusively contralateral whereas clonus occurred in 92% and unilateral tonic posturing in 89% of seizures contralateral to the epileptogenic region. Ictal non-forced head turning and postictal nose wiping showed no lateralizing significance. Dystonic posturing did not occur. Conclusions: Somatosensory aura, head version, ictal cloni, and tonic posturing are reliable lateralizing signs in frontal seizures. These signs may help in identifying the epileptogenic region during presurgical evaluation of patients suffering from frontal lobe epilepsy.

Original languageEnglish
Pages (from-to)125-133
Number of pages9
JournalEpilepsy Research
Volume43
Issue number2
DOIs
Publication statusPublished - 2001

Fingerprint

Frontal Lobe
Seizures
Head
Epilepsy
Stroke
Nose
Electroencephalography
Frontal Lobe Epilepsy
Research Personnel
Patient Rights

ASJC Scopus subject areas

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

Cite this

@article{6cc81415d5124ae58693d0a2a617d971,
title = "Lateralizing value of unilateral motor and somatosensory manifestations in frontal lobe seizures",
abstract = "Purpose: To evaluate the lateralizing value of unilateral somatosensory aura, unilateral tonic posturing, head version, non-forced head turning, ictal cloni, dystonic posturing, and postictal nose wiping in seizures originating in the frontal lobe. Methods: We included patients who had consecutively undergone presurgical evaluation with ictal video-EEG monitoring at our institution, had had resective epilepsy surgery involving the frontal lobe, and had remained seizure-free >1 year after operation. Twenty-seven patients aged 1-42 years (mean 18) met the inclusion criteria. Fifteen patients had right-sided, 12 patients had left-sided epileptogenic regions. Seizures recorded during EEG-video monitoring were re-evaluated by two investigators in order to identify lateralization signs in frontal lobe seizures. One of the investigators was blind to patients' clinical data. Results: We analyzed 153 seizures of 27 patients. The most common unilateral phenomenon was the unilateral tonic posturing occurring in 48{\%} of all the patients and in 25{\%} of all seizures. Somatosensory aura and head version appeared exclusively contralateral whereas clonus occurred in 92{\%} and unilateral tonic posturing in 89{\%} of seizures contralateral to the epileptogenic region. Ictal non-forced head turning and postictal nose wiping showed no lateralizing significance. Dystonic posturing did not occur. Conclusions: Somatosensory aura, head version, ictal cloni, and tonic posturing are reliable lateralizing signs in frontal seizures. These signs may help in identifying the epileptogenic region during presurgical evaluation of patients suffering from frontal lobe epilepsy.",
keywords = "Epilepsy surgery, Frontal lobe epilepsy, Lateralization, Tonic posturing, Video-EEG",
author = "J. Janszky and A. Fogarasi and H. Jokeit and A. Ebner",
year = "2001",
doi = "10.1016/S0920-1211(00)00186-8",
language = "English",
volume = "43",
pages = "125--133",
journal = "Epilepsy Research",
issn = "0920-1211",
publisher = "Elsevier",
number = "2",

}

TY - JOUR

T1 - Lateralizing value of unilateral motor and somatosensory manifestations in frontal lobe seizures

AU - Janszky, J.

AU - Fogarasi, A.

AU - Jokeit, H.

AU - Ebner, A.

PY - 2001

Y1 - 2001

N2 - Purpose: To evaluate the lateralizing value of unilateral somatosensory aura, unilateral tonic posturing, head version, non-forced head turning, ictal cloni, dystonic posturing, and postictal nose wiping in seizures originating in the frontal lobe. Methods: We included patients who had consecutively undergone presurgical evaluation with ictal video-EEG monitoring at our institution, had had resective epilepsy surgery involving the frontal lobe, and had remained seizure-free >1 year after operation. Twenty-seven patients aged 1-42 years (mean 18) met the inclusion criteria. Fifteen patients had right-sided, 12 patients had left-sided epileptogenic regions. Seizures recorded during EEG-video monitoring were re-evaluated by two investigators in order to identify lateralization signs in frontal lobe seizures. One of the investigators was blind to patients' clinical data. Results: We analyzed 153 seizures of 27 patients. The most common unilateral phenomenon was the unilateral tonic posturing occurring in 48% of all the patients and in 25% of all seizures. Somatosensory aura and head version appeared exclusively contralateral whereas clonus occurred in 92% and unilateral tonic posturing in 89% of seizures contralateral to the epileptogenic region. Ictal non-forced head turning and postictal nose wiping showed no lateralizing significance. Dystonic posturing did not occur. Conclusions: Somatosensory aura, head version, ictal cloni, and tonic posturing are reliable lateralizing signs in frontal seizures. These signs may help in identifying the epileptogenic region during presurgical evaluation of patients suffering from frontal lobe epilepsy.

AB - Purpose: To evaluate the lateralizing value of unilateral somatosensory aura, unilateral tonic posturing, head version, non-forced head turning, ictal cloni, dystonic posturing, and postictal nose wiping in seizures originating in the frontal lobe. Methods: We included patients who had consecutively undergone presurgical evaluation with ictal video-EEG monitoring at our institution, had had resective epilepsy surgery involving the frontal lobe, and had remained seizure-free >1 year after operation. Twenty-seven patients aged 1-42 years (mean 18) met the inclusion criteria. Fifteen patients had right-sided, 12 patients had left-sided epileptogenic regions. Seizures recorded during EEG-video monitoring were re-evaluated by two investigators in order to identify lateralization signs in frontal lobe seizures. One of the investigators was blind to patients' clinical data. Results: We analyzed 153 seizures of 27 patients. The most common unilateral phenomenon was the unilateral tonic posturing occurring in 48% of all the patients and in 25% of all seizures. Somatosensory aura and head version appeared exclusively contralateral whereas clonus occurred in 92% and unilateral tonic posturing in 89% of seizures contralateral to the epileptogenic region. Ictal non-forced head turning and postictal nose wiping showed no lateralizing significance. Dystonic posturing did not occur. Conclusions: Somatosensory aura, head version, ictal cloni, and tonic posturing are reliable lateralizing signs in frontal seizures. These signs may help in identifying the epileptogenic region during presurgical evaluation of patients suffering from frontal lobe epilepsy.

KW - Epilepsy surgery

KW - Frontal lobe epilepsy

KW - Lateralization

KW - Tonic posturing

KW - Video-EEG

UR - http://www.scopus.com/inward/record.url?scp=0035147129&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035147129&partnerID=8YFLogxK

U2 - 10.1016/S0920-1211(00)00186-8

DO - 10.1016/S0920-1211(00)00186-8

M3 - Article

C2 - 11164701

AN - SCOPUS:0035147129

VL - 43

SP - 125

EP - 133

JO - Epilepsy Research

JF - Epilepsy Research

SN - 0920-1211

IS - 2

ER -