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Related Experiment Videos

Ictal spitting: clinical and electroencephalographic features.

Christoph Kellinghaus1, Tobias Loddenkemper, Prakash Kotagal

  • 1Department of Neurology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA. kellingc@ccf.org

Epilepsia
|July 31, 2003
PubMed
Summary

Ictal spitting, an uncommon seizure symptom, often indicates epilepsy originating in the right, nondominant hemisphere, particularly temporal lobe epilepsy. This finding helps localize seizure onset during diagnostic evaluations.

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Area of Science:

  • Neurology
  • Epileptology
  • Clinical Neurophysiology

Background:

  • Ictal spitting automatisms are rare seizure manifestations.
  • Understanding their semiology is crucial for localizing the epileptogenic zone.

Purpose of the Study:

  • To identify clinical and electroencephalography (EEG) correlates of ictal spitting.
  • To assess the reliability of ictal spitting in determining the hemisphere of seizure onset.

Main Methods:

  • Retrospective review of the Cleveland Clinic Foundation epilepsy-monitoring database (1994-2002).
  • Analysis of video and EEG data from patients with a history of ictal spitting.

Main Results:

  • Ictal spitting occurred in 0.3% of patients (12/4000).

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  • In most cases (6/7 patients, 12/15 seizures), EEG onset lateralized to the right, nondominant hemisphere.
  • Spitting often occurred with fast, high-amplitude theta activity in the temporal region of seizure onset.

    • Conclusions:

    • Ictal spitting is an infrequent but significant seizure feature.
    • It is most commonly associated with temporal lobe epilepsy originating in the right, nondominant hemisphere.