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Gyratory seizures revisited: a video-EEG study
J Dobesberger1, G Walser, N Embacher
1Universitätskliniken für Neurologie, Innsbruck, Austria. eugen.trinka@uklibk.ac.at
Neurology
|June 16, 2005
Summary
Gyratory seizures (GSs) can help lateralize epilepsy onset. Rotation direction indicates the seizure origin, with specific patterns observed in frontal and temporal lobe epilepsies.
Area of Science:
- Neurology
- Epileptology
- Clinical Neuroscience
Background:
- Gyratory seizures (GSs), characterized by body axis rotation (≥180°), are infrequently documented in generalized and focal epilepsies.
- The underlying mechanisms and clinical significance of GSs remain incompletely understood and debated.
Purpose of the Study:
- To comprehensively describe the semiology of gyratory seizures.
- To evaluate the potential of GSs to lateralize and localize the seizure onset zone in patients with epilepsy.
Main Methods:
- Screening of 277 consecutive patients with intractable epilepsy undergoing presurgical evaluation.
- Classification of epilepsy types: temporal lobe epilepsy (TLE), frontal lobe epilepsy (FLE), generalized epilepsies (GE), and extratemporal/multifocal epilepsy.
Main Results:
- Twelve patients experienced 17 seizures with gyratory movements; 8 had FLE and 4 had TLE (p < 0.001).
- In 58% of cases, GSs began with forced head version, followed by rotation contralateral to seizure onset.
- In 42% of cases, GSs lacked preceding head version, with rotation direction indicating the ipsilateral seizure onset zone.
Conclusions:
- GSs demonstrate lateralizing value in focal epilepsy, contingent on seizure evolution.
- GSs initiating with head version lateralize to the contralateral hemisphere; those without head version lateralize ipsilaterally.
- GSs are more prevalent in FLE than TLE; they were not observed in the studied GE patients.