Gyratory seizures revisited

Abstract

The direction of rotation lateralizes seizure onset zone in focal epilepsy depending on the seizure evolution: 1) gyratory seizures (GSs) starting with a forced version of the head ensuing into a body rotation lateralize seizure onset zone contralateral to the direction of rotation. 2) In GSs without a preceding gyratory forced head version, the direction of rotation is toward the side of seizure onset. GSs occur more frequently in frontal lobe epilepsy than temporal lobe epilepsy, while none of our patients with GSs had generalized epilepsies.

Central Vertigo and Dizziness

“…Thalamic stimulation also has been shown experimentally to induce circling movements. 56,57 Seizures evoked by vestibular stimulation (during caloric testing) are called vestibulogenic seizures and are complex partial or secondarily generalized seizures. Vertigo can not be always seen during such evoked seizures.…”

Ictal body turning in focal epilepsy

“…It was stated in a study with patients with epilepsy who had 180°and greater amounts of body turning during seizures that ictal body turning was frequently present in frontal lobe epilepsies (17%) and rarely occurs in temporal lobe epilepsies (2%). It was also stated in the same study that if VHT was present before body turning, the EZ was contralateral to the body's rotation side, and if body turning did not have VHT, then it was ipsilateral to the body's rotation side [3]. A study on patients who exhibited trunk rotation of over 90°and longer than 10 s revealed that the EZ was 92% contralateral to the rotation side [4].…”

“…Investigating different clinical symptoms and electroencephalography (EEG) recordings of the cortical areas activated by the EZ has revealed relationships between these behaviors and localization and lateralization of the EZ [1,2]. However, there are not enough data on the occurrence of body turning during seizures of patients with focal epilepsy, and only a few studies have investigated the role of EZ detection in ictal body turning [3][4][5]. Seizures containing ictal body turning are known as rotatory, volvular, circling, and gyratory seizures in the literature.…”

“…These seizures were observed by Gastaut et al in primarily generalized epilepsy and were defined as turning of half of the body. However, some authors have stated that these seizures can also occur in focal epilepsy and defined them as at least a 180°rotation around the body axis [3,9].…”

Seizure Semiology: An Overview of the ‘Inverse Problem’

“…In this context, seizures with violent behavioral manifestations and fear tend to arise from the ventromesial frontal regions, whereas relatively mild, horizontal movements coupled with dystonia are mostly seen when the mesial premotor cortex is involved [35]. Gyratory seizures have been reported to result from activation of the contralateral frontotemporal region if heralded by forced head turning, and ipsilateral if presenting with an en bloc version of the body [36]; furthermore, rotations around the horizontal body axis seem to be predictive of a mesial frontal origin [37]. …”