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Published on: December 18, 2016
Lateralizing signs during seizures in focal epilepsy
Tobias Loddenkemper1, Prakash Kotagal
1Department of Neurology, The Cleveland Clinic Foundation, Cleveland, OH, USA.
Epilepsy & Behavior : E&B
|June 25, 2005
Summary
Recognizing lateralizing signs during epileptic seizures helps predict the epileptogenic zone, aiding epilepsy surgery evaluations. This review details various semiological signs with diagnostic value for presurgical planning.
Area of Science:
- Neurology
- Epileptology
- Neurosurgery
Background:
- Epilepsy surgery requires precise localization of the epileptogenic zone.
- Semiological signs during seizures offer clues to the seizure's origin.
- Understanding cortical representation is key to interpreting these signs.
Purpose of the Study:
- To review lateralizing semiological signs in epileptic seizures.
- To assess their value in predicting the epileptogenic zone.
- To highlight their importance in presurgical diagnosis for epilepsy surgery.
Main Methods:
- Review of literature on semiological signs and their lateralizing significance.
- Analysis of various seizure manifestations, including auras, ictal, and postictal features.
- Correlation of signs with known cortical representation.
Main Results:
- Numerous semiological signs (visual, auditory, motor, autonomic, language, postictal) demonstrate lateralizing value.
- Specific examples include ictal version, unilateral spasms, Todd's palsy, and postictal aphasia.
- These signs provide crucial information for localizing the seizure focus.
Conclusions:
- Knowledge of lateralizing semiological signs is vital for presurgical epilepsy evaluation.
- These signs complement other diagnostic tools like video/EEG and neuroimaging.
- Accurate interpretation aids in identifying candidates for epilepsy surgery and improving outcomes.
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