Ictal kissing with subdural EEG recording

Area of Science:

• Neurology
• Epileptology
• Clinical Neuroscience

Background:

• Ictal kissing is a rare ictal semiology.
• Previous reports link it to temporal lobe epilepsy (TLE) lateralizing to the nondominant hemisphere.

Purpose of the Study:

• To present a case of ictal kissing.
• To detail its clinical, electrophysiological, and imaging features.
• To correlate findings with existing literature.

Main Methods:

• Case identification and detailed clinical observation.
• Electrophysiological recording using subdural electrodes.
• Review of neuroimaging (MRI, PET), surgical, and histopathology data.

Main Results:

• A 29-year-old female with right TLE exhibited ictal kissing preceded by dystonic posturing and lip smacking.
• MRI revealed right frontal lobe lesions; PET showed right temporal hypometabolism.
• Subdural EEG indicated discharges originating in the right mesial temporal lobe with spread to the right frontal lobe.

Conclusions:

• This case supports ictal kissing lateralizing to the nondominant hemisphere, confirmed by subdural EEG.
• Spread of epileptic discharges to the frontal lobe was observed during affectionate kissing behavior.