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Ictal pleasant sensations: cerebral localization and lateralization
Hermann Stefan1, Andreas Schulze-Bonhage, Elisabeth Pauli
1Neurologische Klinik, Zentrum Epilepsie der Universität Erlangen-Nürnberg, Erlangen-Nürnberg, Germany. hermann.stefan@neuro.imed.uni-erlangen.de
Epilepsia
|December 25, 2003
Summary
Ictal pleasant feelings, a rare epilepsy symptom, often originate in the temporal lobe, specifically mesiobasal areas. This study suggests ictal happiness can help localize focal epilepsy origins.
Area of Science:
- Neurology
- Epileptology
- Clinical Neuroscience
Background:
- Ictal pleasant feelings are an uncommon manifestation of focal epilepsies.
- Literary descriptions exist, but robust evidence on cerebral localization is lacking.
Purpose of the Study:
- To investigate the cerebral localization of focal epileptic seizures associated with ictal pleasant feelings.
- To determine if ictal happiness serves as a localizing sign in epilepsy.
Main Methods:
- Retrospective analysis of 11 patients experiencing ictal pleasant feelings.
- Electroencephalography (EEG) and neuroimaging to identify seizure origin.
- Clinical evaluation of seizure semiology and localization.
Main Results:
- Eight patients had focal epileptic activity originating in the temporal lobe (predominantly temporal inferior basal regions).
- Three patients showed additional frontal or parietal lobe involvement.
- Ictal happiness was localized to mesiobasal temporal areas, with lateralization to the right (7 patients) or left (4 patients) temporal lobe.
Conclusions:
- Ictal pleasant feelings are a localizing sign for focal epilepsy.
- The findings strongly suggest ictal involvement of temporal mesiobasal areas.
- This symptom aids in lateralizing seizure origin within the temporal lobe.