Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-25T09:48:15.173Z Has data issue: false hasContentIssue false

Contralateral Motor Automatisms in Neocortical Temporal Lobe Epilepsy

Published online by Cambridge University Press:  02 December 2014

Seyed M. Mirsattari
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
Donald H. Lee
Affiliation:
Department of Radiology, University of Western Ontario, London, Ontario, Canada
Warren T. Blume
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

The lateralizing value of the motor automatisms is generally doubted in most patients with temporal lobe epilepsy. However, subgroup analysis of the seizures of temporal lobe origin suggests a role for motor automatisms in discriminating seizures of neocortical versus mesial temporal lobe origin.

Methods:

Video-EEG of a patient with well-defined neocortical temporal lobe epilepsy was reviewed to assess the localizing value of motor automatisms.

Results:

We report a patient with left upper extremity motor automatisms and clonic movements of the proximal left lower extremity with altered awareness as the sole manifestations of right temporal neocortical seizures.

Conclusion:

Early onset unilateral motor automatisms without dystonic posturing can localize the seizure origin to the contralateral temporal lobe neocortex.

Type
Case Report
Copyright
Copyright © The Canadian Journal of Neurological 2004

References

1.Dupont, S, Semah, F, Boon, P, et al. Association of ipsilateral motor automatisms and contralateral dystonic posturing. Arch Neurol 1999; 56:927932.CrossRefGoogle ScholarPubMed
2.Chee, MWL, Kotagal, PVan Ness, PC, et al. Lateralizing signs in intractable partial epilepsy: blinded multiple-observer analysis. Neurology 1993; 43:25192525.Google Scholar
3.Jasper, HH.Some physiological mechanisms involved in epileptic automatisms. Epilepsia 1964; 5:120.CrossRefGoogle ScholarPubMed
4.Bleasel, A, Kotagal, P, Kankirawatana, P, Rybicki, L.Lateralizing value and semiology of ictal limb posturing and version in temporal lobe and extratemporal epilepsy. Epilepsia 1997; 38:168174.Google Scholar
5.Kotagal, P, Luders, H, Morris, HH, et al. Dystonic posturing in complex partial seizures of temporal lobe onset: a new lateralizing sign. Neurology 1989; 39:196201.CrossRefGoogle ScholarPubMed
6.Berkovic, SF, Bladin, PF.An electroclinical study of complex partial seizures [abstract]. Epilepsia 1984; 25:668669.Google Scholar
7.Wada, JA.Cerebral lateralization and epileptic manifestations. In: Akimoto, H, Kazamatsuri, H, Seino, M, Ward, AA, eds. Advances in Epileptology: XIIIth Epilepsy International Symposium. New York: Raven Press, 1982: 365372.Google Scholar
8.Marks, WJ Jr, Laxer, KD.Semiology of temporal lobe seizures: value in lateralizing the seizure focus. Epilepsia 1998; 39:721726.Google Scholar
9.Serles, W, Pataraia, E, Bacher, J, et al. Clinical seizure lateralization in mesial temporal lobe epilepsy: differences between patients with unitemporal and bitemporal interictal spikes. Neurology 1998; 50:742747.Google Scholar
10.Quesney, LF.Clinical and EEG features of complex partial seizures of temporal lobe origin. Epilepsia 1986; 27:S27-S45.CrossRefGoogle ScholarPubMed
11.Blume, WT, Luders, HO, Mizrahi, E, et al. Glossary of descriptive terminology for ictal semiology: report of the ILAE task force on classification and terminology. Epilepsia 2001; 42:12121218.CrossRefGoogle ScholarPubMed
12.Gil-Nagel, A, Risinger, MW.Ictal semiology in hippocampal versus extrahippocampal temporal lobe epilepsy. Brain 1997; 120:183192.Google Scholar
13.Geier, S, Bancaud, J, Talairach, J, et al. Automatisms during frontal lobe epileptic seizures. Brain 1976; 99:447458.Google Scholar
14.Talairach, J, Bancaud, J, Geier, S, et al. The cingulated gyrus and human behavior. Electroencephalogr Clin Neurophysiol 1973; 34:4552.Google Scholar
15.Rosene , DL, Van Hoesen, GW.Hippocampal efferents reach widespread areas of the cerebral cortex and amygdala in the rhesus monkey. Science 1977; 198:315317.CrossRefGoogle ScholarPubMed
16.Nauta, HJW.A simplified perspective on the basal ganglia and their relation to the limbic system. In: Doane, BK, Livingston, KE, (Eds). The Limbic System: Functional Organization and Clinical Disorders. New York: Raven Press, 1986: 6777.Google Scholar
17.Yang, CR, Mogenson, GJ.An electrophysiological study of the neural projections from the hippocampus to the ventral pallidum and the subpallidal areas by way of the nucleus accumbens. Neuroscience 1985; 15:10151024.CrossRefGoogle Scholar
18.Newton, MR, Berkovic, SF, Austin, MC, et al. Dystonia, clinical lateralization, and regional blood flow changes in temporal lobe seizures. Neurology 1992; 42:371377.Google Scholar
19.Russchen, FT, Bakst, I, Amaral, DG.The amygdalostriatal projections in the monkey: an anterograde tracing study. Brain Res 1985;329:241257.Google Scholar
20.Morris, HH, Kanner, A, Luders, H, et al. Can sharp waves localized at the sphenoidal electrode accurately identify a mesio-temporal epileptogenetic focus? Epilepsia 1989; 30:532539.Google Scholar
21.Risinger, MW, Engel, J Jr, Van Ness, PC, et al. Ictal localization in temporal lobe seizures with scalp/sphenoidal recordings. Neurology 1989; 39:12881293.Google Scholar
22.Ebersole, JS, Wade, PD.Spike voltage topography identifies two types of frontotemporal epileptic foci. Neurology 1991; 41:14251433.Google Scholar
23.Rowe, CC, Berkovic, SF, Austin, MC, et al. Patterns of postictal cerebral blood flow in temporal lobe epilepsy: quantitative and qualitative analysis. Neurology 1991: 41:10961103.Google Scholar
24.Henry, TR, Sutherling, WW, Engel, J Jr, et al. Interictal cerebral metabolism in partial epilepsies of neocortical origin. Epilepsy Res 1991; 10:174182.Google Scholar
25.Hajek, M, Antonini, A, Leenders, KL, Wieser, HG.Mesiobasal versus lateral temporal lobe epilepsy: metabolic differences in the temporal lobe shown by interictal 18F-FDG positron emission tomography. Neurology 1993; 43:7986.Google Scholar
26.Wieser, HG.Discussion of 5 typical seizure constellation in the light of neuroanatomy. In: Wieser, HG.Electroclinical Features of the Psychomotor Seizure. Stuttgart-London: Gustav Fischer-Butterworths, 1983: 193208.Google Scholar
27.Walsh, GO, Delgado-Escueta, AV. Type II complex partial seizures: poor results of anterior temporal lobectomy. Neurology 1984;34:113.Google Scholar
28.Delgado-Escueta, AV, Walsh, GO.Type I complex partial seizures of hippocampal origin: excellent results of anterior temporal lobectomy. Neurology 1985; 35:143154.Google Scholar
29.Maldonado, HM, Delgado-Escueta, AV, Walsh, GO, et al. Complex partial seizures of hippocampal and amygdalar origin. Epilepsia 1988; 29:420433.Google Scholar
30.Kotagal, P, Luders, HO, Williams, G, et al. Psychomotor seizures of temporal lobe onset: analysis of symptom clusters and sequences. Epilepsy Res 1995; 20:4967.Google Scholar
31.Anand, I, Kotagal, P, Hammel, J, Mascha, E.Seizure semiology of lateral versus mesial temporal lobe epilepsy using statistical analysis. Neurology 1997; 48:A240-A241.Google Scholar