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Contralateral motor automatisms in neocortical temporal lobe epilepsy
Seyed M Mirsattari1, Donald H Lee, Warren T Blume
1Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada.
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.