Sexual ictal manifestations predominate in women with temporal lobe epilepsy

Rémillard, Guy M.; Andermann, Frédérick; Testa, Gian Franco; Gloor, P.; Aubé, Michel; Martin, Joseph B.; Feindel, William; Guberman, A.; Simpson, Charles Blakely

doi:10.1212/wnl.33.3.323

Cited by 123 publications

(77 citation statements)

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“…Spitting automatism occurred during right temporal seizures as it is found in the literature 18 , representing a lesser common type of oral motor automatism 23 . Sexual automatisms are more related to right temporal seizures 24 , although in our casuistics they were found in left and right TLS. Mimic automatism of smile occurred predominantly in neocortical seizures, a fact reported by Hiyoshi et al 25 .…”

Section: Discussioncontrasting

confidence: 56%

Clinical and eeg analysis of mesial and lateral temporal lobe seizures

Dantas¹,

Yacubian

Jorge³

et al. 1998

Arq. Neuro-Psiquiatr.

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-The analysis of the temporal lobe seizures through video-EEG systems shows that they often consist of a sequence of clinical and EEG features which may suggest the localization and the lateralization of the epileptogenic lobe. We analyzed clinical and EEG features of 50 temporal lobe seizures which were separated in group 1 with 25 patients (related to mesial temporal sclerosis) and group 2 with 25 patients (other neocortical temporal lesions). Among the auras, the epigastric type was the most frequent and predominated in group 1. There were differences between the two groups, considering dystonic and tonic posturing and versive head and eye movements. Dystonic posturing was always contralateral to the ictal onset and was considered the most useful lateralizing clinical feature. Ictal speech, spitting and blinking automatisms, prolonged disorientation for place and a greatest percentage of postictal language preservation occurred in right temporal seizures. Postictal aphasia and global disorientation predominated in left temporal seizures. EEG was important for lateralizing the epileptogenic lobe, specially considering rhythmic ictal activity and postictal findings.KEY WORDS: temporal lobe epilepsy, complex partial seizures, video-EEG.Análise clínica e eletrencefalográfica de crises epilépticas temporais de origem mesial e lateral RESUMO -As crises epilépticas do lobo temporal tendem a seguir uma sequência previsível de eventos clínicos e eletrencefalográficos, cuja análise, preferencialmente através de sistemas de vídeo-EEG, sugere a localização e a lateralização do lobo epileptogênico. Para este estudo, foram analisadas 50 crises epilépticas do lobo temporal, do ponto de vista clínico e eletrencefalográfico, sendo 25 relacionadas a esclerose mesial (grupo 1) e 25 a patologias neocorticais (grupo 2). Auras abdominais foram as mais frequentes, predominando no grupo 1. Houve diferenças entre os dois grupos, quanto à instalação e duração da postura distônica, à postura tônica e à versão oculocefálica. Postura distônica unilateral foi o mais importante fenômeno clínico lateralizatório, sempre contralateral à área epileptogênica. Verbalização crítica, automatismo de cuspir, piscamento palpebral bilateral, desorientação espacial prolongada e maior percentual de preservação da linguagem no período pós-crítico foram relacionados a crises temporais direitas. Afasia pós-crítica e desorientação global, a crises temporais esquerdas. O EEG teve importante acurácia lateralizatória em ambos os grupos, especialmente quanto à atividade crítica rítmica e achados pós-críticos. PALAVRAS-CHAVE: epilepsia do lobo temporal, crises parciais complexas, vídeo-EEG.According to the International Classification of Epilepsies and Epileptic Syndromes 1 , these can be divided in partial, generalized, epilepsies and syndromes undetermined whether focal or generalized and special syndromes. Temporal lobe epilepsy (TLE) is responsible for 60% of all the partial epileptic seizures 2 and it has been extensively studied clinically, electr...

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Section: Discussioncontrasting

confidence: 56%

Clinical and eeg analysis of mesial and lateral temporal lobe seizures

Dantas¹,

Yacubian

Jorge³

et al. 1998

Arq. Neuro-Psiquiatr.

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“…Women patients with temporal lobe seizures have been more frequently reported than men [4]. The onset of seizure has been observed to be at a relatively late age with the mean age being 27 years [5]. The patient in our case report is a female aged 29 years.…”

Section: Discussionmentioning

confidence: 78%

“…Sexual automatism of frontal lobe origin may also follow sexual auras originating from anterior temporal lobe foci. It has been further suggested that sexual emotions or the sexual auras may be localized in the temporal lobe portion of the limbic system and the complex motor behaviour or sexual automatisms may be localised to the frontal lobe portion of the limbic system [5].…”

Section: Discussionmentioning

confidence: 99%

Seizure Related Sexual Disorder

Mayanil

Valdiya

Singh

1999

Medical Journal Armed Forces India

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“…In three patients, pleasant sexual ictal manifestations were reported, whereas unpleasant or neutral sensations in the genitalia were observed during discharges of the postcentral gyrus or the perisylvian region (16,17). Erotically pleasurable, sexual, or orgasm sensations in women were located in the limbic portion of the temporal lobe (18). Cognitive and affective modality-specific processing of humor is expressed in medial ventral prefrontal cortex and in the middle and inferior temporal gyrus (19).…”

Section: Fig 1 Amentioning

confidence: 99%

Ictal Pleasant Sensations: Cerebral Localization and Lateralization

et al. 2003

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Summary:Ictal pleasant feelings are a rare sign of focal epilepsies. The most popular description was performed by Dostojevskij, who reported an aura by Myshken in one of his books. No convincing evidence has been published concerning the cerebral localization of ictal happiness. In this study, the findings of 11 patients with ictal pleasant feelings are described. In eight patients, the origin of the focal epileptic activity was found in the temporal lobe (most often temporal inferior basal); in three patients, frontal or parietal lobe in addition to temporal lobe involvement was found. According to our findings ictal happiness is a localizing sign pointing to the ictal involvement of temporal mesiobasal areas. Lateralization to the right temporal lobe was found in seven and to the left temporal lobe in four patients.

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Sexual ictal manifestations predominate in women with temporal lobe epilepsy

Cited by 123 publications

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Clinical and eeg analysis of mesial and lateral temporal lobe seizures

Clinical and eeg analysis of mesial and lateral temporal lobe seizures

Seizure Related Sexual Disorder

Ictal Pleasant Sensations: Cerebral Localization and Lateralization

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