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Electrode manipulation automatism during temporal lobe seizures.

A Fogarasi¹, G Rásonyi, A Kelemen

¹Epilepsy Center, National Institute of Psychiatry and Neurology, Budapest, Hungary. fogarasi@bethesda.hu

|June 21, 2006

Summary

Peri-ictal electrode manipulation automatism (EMA) is common in temporal lobe epilepsy (TLE) but does not help lateralize seizures. EMA

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Area of Science:

Clinical Neurology
Epileptology
Neurophysiology

Background:

Temporal lobe epilepsy (TLE) is a common focal epilepsy.
Automatisms are frequent seizure manifestations in TLE.
Electrode manipulation automatism (EMA) is a specific type of automatism.

Purpose of the Study:

To characterize peri-ictal electrode manipulation automatism (EMA) in temporal lobe epilepsy (TLE).
To assess the lateralizing value of EMA in TLE.
To compare EMA with other ictal manual automatisms.

Main Methods:

Analysis of 205 videotaped seizures from 55 refractory TLE patients.
Monitoring for peri-ictal electrode manipulation automatism (tugging, scratching, adjusting electrodes/cables).
Correlation of EMA with seizure lateralization and other seizure components.

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Main Results:

EMA occurred in 51% of patients during 23% of seizures.
EMA was associated with automotor seizure components.
EMA showed no significant difference between left-sided and right-sided seizures (p = 0.742).
Unilateral EMA occurred ipsilateral to the seizure onset zone in 17/24 cases (p = 0.064).

Conclusions:

Peri-ictal EMA is a frequent observation in TLE.
EMA does not provide reliable lateralization for TLE seizures.
The underlying mechanism of EMA differs from previously described manual automatisms.