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Ictal pallor is associated with left temporal seizure onset zone in children

András Fogarasi1, József Janszky, Ingrid Tuxhorn

  • 1Epilepsie-Zentrum Bethel, Bielefeld, Germany; Epilepsy Center, Bethesda Children's Hospital, H-1146-Budapest, Bethesda Street 3, Hungary. fogarasi@bethesda.hu

Epilepsy Research
|October 20, 2005
PubMed

Insights

Ictal pallor (IP) is a useful indicator in children with focal epilepsy, predicting seizure onset in the left temporal lobe. This autonomic symptom aids in localization, especially in young patients.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Autonomic Nervous System

Background:

  • Focal epilepsy in children presents diagnostic challenges.
  • Autonomic symptoms, like ictal pallor, are potential indicators of seizure origin.
  • Accurate localization is crucial for effective treatment of pediatric epilepsy.

Purpose of the Study:

  • To determine the frequency of ictal pallor (IP) in children with focal epilepsy.
  • To evaluate the localizing and lateralizing value of IP.
  • To assess the utility of IP in identifying seizure onset zones.

Main Methods:

  • Retrospective review of medical charts and archived seizures from 100 children (≤12 years old) with therapy-resistant partial epilepsy.
  • Analysis of the presence and characteristics of ictal pallor.
  • Correlation of IP with seizure onset zone and surgical outcomes.

Main Results:

  • Ictal pallor was reported in 11% of children based on medical charts, but not detected on video review.
  • IP was significantly associated with left temporal lobe epilepsy (90% of cases).
  • Presence of IP demonstrated a 91% positive predictive value for left-sided temporal lobe seizure onset.

Conclusions:

  • Ictal pallor is a valuable, though difficult to video-assess, autonomic symptom in childhood focal seizures.
  • IP has a high predictive value for localizing seizure onset to the left temporal region in pediatric patients.
  • This finding aids in early localization and management of focal epilepsy in children.
Abstract

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