Lateralizing Signs in Mesial Temporal Lobe Epilepsy

Keimyung Medical Journal 1997;16(4):531-537.

내측측두엽 간질환자에서의 측위증후

김지언

Abstract

Various signs of lateralization have been described in temporal lobe epilepsy (TLE). They include unilateral automatism; unilateral dystonic posture; versive head and body turning; ictal speech and so on. Because their specificity is still unclear; they are used to a limited degree in lateralizing the side of ictal onset. We evaluate the value of lateralizing signs in patients with TLE. We analyzed semiology of 180 seizures in 35 TLE patients who were evaluated for epilepsy surgery at Dongsan Epilepsy Center between November; 1992 and October; 1995. All patients had received epilepsy surgery; and they were seizure free or exhibited aura only for at least 12 months following surgical resection. Unilateral dystonic posture alone was observed in 22 seizures [ipsilateral: 6(25%); contralateral: 16(75%)]. Unilateral hand automatism alone was observed in 33 seizures [ipsilateral: 23(70%)’ contralateral： 10(30%)]. Unilateral dystonic posture accompanied by automatism of the other side was observed in 56 seizures [ipsilateral automatism combined with contralateral dystonic posture- 48(87%); contralateral automatism combined with ipsilateral dystonic posture: 7(13%)]. Versive head turning was noticed in 35 events [ipsilateral 4(11%); contralateral: 22(63%); initial ipsilateral to contralateral： 9(26%); initial contralateral to ipsilateral: 0]. We conclude that the most valuable lateralizing sign in TLE is contralateral dystonic posture accompanied by ipsilateral automatism; and ipsilateral hand automatism alone and contralateral dystonic posture alone are also significant.

Key Words: Mesial temporal lobe epilepsy, Lateralizing sign, Semiology