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Ictal smile lateralizes to the right hemisphere in childhood epilepsy

András Fogarasi1, József Janszky, Zsuzsanna Siegler

  • 1Epilepsie-Zentrum Bethel, Bielefeld, Maraweg, Germany.

Epilepsia
|February 26, 2005
PubMed

Insights

Ictal smile (IS) in childhood epilepsy frequently lateralizes to the right hemisphere. This symptom is more common in posterior cortex epilepsy, offering valuable localization insights.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Clinical Neurophysiology

Background:

  • Ictal smile (IS) is an uncommon manifestation in childhood epilepsy.
  • Understanding its diagnostic value is crucial for precise localization and lateralization.

Purpose of the Study:

  • To investigate the localizing and lateralizing significance of ictal smile (IS) in children with epilepsy.
  • To determine the association of IS with specific epilepsy syndromes and etiologies.

Main Methods:

  • Analysis of 309 videotaped seizures from 114 pediatric patients (<12 years) with refractory epilepsy.
  • Assessment of IS incidence across frontal, temporal, and posterior cortex epilepsy.
  • Statistical analysis including chi-squared tests and logistic regression.

Main Results:

  • IS occurred in 21% of patients with right-sided epileptogenic zones versus 1.8% with left-sided epilepsy (p < 0.01).
  • Incidence was 11% (frontal), 3% (temporal), and 26% (posterior cortex).
  • Posterior cortex localization, focal cortical dysplasia, and right-sided lateralization were independently associated with IS.

Conclusions:

  • Childhood ictal smile (IS) is a significant indicator that lateralizes to the right hemisphere.
  • IS has a higher frequency in posterior cortex epilepsy, aiding in epilepsy localization.
Abstract

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