Contralateral Motor Automatisms in Neocortical Temporal Lobe Epilepsy

Mirsattari, Seyed M.; Lee, Donald H.; Blume, Warren T.

doi:10.1017/s031716710000295x

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…However, in the current study, three patients who had unilateral hand automatism without contralateral dystonic posturing in PLTLE had their seizure focus lateralized to the contralateral hemisphere and their unilateral hand automatisms evolved to unilateral tonic posturing. This result is similar to the previous findings [28,29]. This type of automatism was called "dystonic automatisms."…”

Section: Ictal Behaviorsupporting

confidence: 91%

Electroclinical characteristics of posterior lateral temporal epilepsy

Wang

Liu

Pan

et al. 2013

Epilepsy & Behavior

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Section: Ictal Behaviorsupporting

confidence: 91%

Electroclinical characteristics of posterior lateral temporal epilepsy

Wang

Liu

Pan

et al. 2013

Epilepsy & Behavior

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“…Some authors have reported that early onset unilateral motor automatisms, without dystonic posturing, can localize seizure origin to the contralateral temporal lobe neocortex [45]. nTLE-originating temporal lobe seizures are seemingly less common than mesial temporal lobe seizures and as a result are less well characterized.…”

Section: Mesial Temporal Lobe Seizures and Neocortical Temporal Lomentioning

confidence: 99%

“…Some authors, however, dispute this and found no lateralizing value of upper limb automatisms in isolation [11, 60, 61]. Other authors, however, reported that early onset unilateral motor automatisms without dystonic posturing can localize seizure origin to the contralateral temporal lobe neocortex [45]. Unilateral ictal blinking (winking) is a rare automatism and usually indicates an ipsilateral focus [62].…”

Section: Lateralizing Features In Temporal Lobe Epilepsymentioning

confidence: 99%

Temporal Lobe Epilepsy Semiology

Blair

2012

Epilepsy Research and Treatment

111

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Epilepsy represents a multifaceted group of disorders divided into two broad categories, partial and generalized, based on the seizure onset zone. The identification of the neuroanatomic site of seizure onset depends on delineation of seizure semiology by a careful history together with video-EEG, and a variety of neuroimaging technologies such as MRI, fMRI, FDG-PET, MEG, or invasive intracranial EEG recording. Temporal lobe epilepsy (TLE) is the commonest form of focal epilepsy and represents almost 2/3 of cases of intractable epilepsy managed surgically. A history of febrile seizures (especially complex febrile seizures) is common in TLE and is frequently associated with mesial temporal sclerosis (the commonest form of TLE). Seizure auras occur in many TLE patients and often exhibit features that are relatively specific for TLE but few are of lateralizing value. Automatisms, however, often have lateralizing significance. Careful study of seizure semiology remains invaluable in addressing the search for the seizure onset zone.

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“…Contralateral upper extremity automatisms have been described in neocortical TLE (Dupont et al, 1999). Mirsattari et al (2004) described a single case with contralateral motor automatisms in neocortical epilepsy. The description of the type of the automatisms was similar to our NMUEAs.…”

Section: Discussionmentioning

confidence: 99%

Nonmanipulative proximal upper extremity automatisms lateralize contralaterally in temporal lobe epilepsy

Kelemen¹,

Fogarasi

Borbély³

et al. 2010

Epilepsia

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Summary Purpose: Upper extremity automatisms are considered to be an ipsilateral seizure lateralizing sign in temporal lobe epilepsy (TLE). Herein we describe different types of contralateral upper extremity automatisms (CUEAs). Methods: One hundred ninety‐three video–(electroencephalography) EEG recordings of 59 patients were reviewed. Other than two patients who refused surgery, all patients underwent standardized temporal lobectomy with favorable postoperative outcome. Fifty‐seven seizures of 21 patients were selected with CUEAs. We evaluated their electroclinical characteristics and their relation to other lateralizing motor symptoms. Results: Two types of CUEAs were observed. Nonmanipulative, proximal upper extremity automatisms were seen unilaterally and contralaterally to the operated side. These automatisms were rhythmic; repetitive; and often occurred with a circulatory component resembling waving, flaunting, circling, or stirring movements. They occurred in 29 seizures (15%) of 11 patients (19%), in most seizures in the first half of the seizure, and never postictally, in various time sequences and combined with dystonic/tonic posturing or limb immobility. Manipulative/distal type of CUEAs occurred in 11 seizures (6%) of 7 patients (12%) on the unexpected contralateral side. These CUEAs were seen in all phases of the seizures, including in the postictal state. Discussion: Nonmanipulative unilateral proximal upper extremity automatism is a reliable lateralizing sign to the contralateral hemisphere in TLE. This sign may be pathophysiologically related to dystonic/tonic posturing. Manipulative distal automatisms have less lateralizing value.

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Contralateral Motor Automatisms in Neocortical Temporal Lobe Epilepsy

Cited by 4 publications

References 26 publications

Electroclinical characteristics of posterior lateral temporal epilepsy

Electroclinical characteristics of posterior lateral temporal epilepsy

Temporal Lobe Epilepsy Semiology

Nonmanipulative proximal upper extremity automatisms lateralize contralaterally in temporal lobe epilepsy

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