Psychomotor seizures of temporal lobe onset: Analysis of symptom clusters and sequences

We analyzed 91 psychomotor seizures from 31 patients seizure free at least one year after temporal lobectomy (implying temporal lobe onset). Fifty symptoms were looked for in every seizure and their time of onset and ending noted. Statistical analysis was used to define symptom clusters and the orde...

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Bibliographic Details
Published in:Epilepsy research 1995, Vol.20 (1), p.49-67
Main Authors: Kotagal, Prakash, Lüders, Hans Otto, Williams, George, Nichols, Thom R., McPherson, Joseph
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cluster Analysis
Complex partial seizures
Diagnosis, Differential
Electroencephalography
Epilepsy, Complex Partial - diagnosis
Epilepsy, Temporal Lobe - surgery
Follow-Up Studies
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Seizures - diagnosis
Symptom analysis
Temporal lobe
Treatment Outcome
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Summary:We analyzed 91 psychomotor seizures from 31 patients seizure free at least one year after temporal lobectomy (implying temporal lobe onset). Fifty symptoms were looked for in every seizure and their time of onset and ending noted. Statistical analysis was used to define symptom clusters and the order of appearance of symptoms. Of the eighteen most common symptoms examined, all of these symptoms form a tight cluster showing a high degree of correlation. Within this cluster, there was a tendency towards the following subclusters: (a) epigastric aura, ictal vomiting, alimentary and hand automatisms; (b) behavioral arrest, complete loss of consciousness, staring and bilateral facial contraction; (c) unilateral dystonic posturing of an arm, mimetic automatisms, complex gestures, ictal speech and partial loss of consciousness; (d) looking around, agitation, vocalizations and whole body movements. We also found a strong correlation between epigastric sensation and ictal vomiting in psychomotor seizures arising from the right but not the left temporal lobe. The commonest sequence of symptoms was: behavioral arrest followed by alimentary and hand automatisms, looking around and whole body movements, in that order.
ISSN:0920-1211
1872-6844
DOI:10.1016/0920-1211(94)00055-2