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Eye movements differ between ictal ipsilateral and contralateral head turning.

Leyla Baysal-Kirac1, Jan Rémi1, Anna Mira Loesch1

  • 1Epilepsy Center, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany.

Epilepsy Research
|June 20, 2015
PubMed
Summary

The sequence of head and eye movements during focal epilepsy seizures differs based on whether head turning is ipsilateral or contralateral to seizure onset. This finding aids in lateralizing the epileptogenic zone.

Keywords:
Frontal eye fieldFrontal lobe epilepsyIctal head turningSaccadic eye movementsTemporal lobe epilepsyVersion

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Area of Science:

  • Neurology
  • Epileptology
  • Clinical Neurophysiology

Background:

  • Ictal head turning is a semiological feature in focal epilepsies.
  • Understanding the relationship between head and eye movements during seizures can aid in localizing the seizure onset zone.

Purpose of the Study:

  • To evaluate the relationship between head and eye movements during ipsilateral and contralateral ictal head turning.
  • To determine if this relationship aids in lateralizing the epileptogenic zone in focal epilepsies.

Main Methods:

  • Retrospective review of video-electroencephalography (EEG) data from patients with focal epilepsies exhibiting ictal head turning.
  • Analysis of 27 seizures with ipsilateral head turning and 40 seizures with contralateral head turning from 19 and 32 patients, respectively.
  • Categorization of epilepsy types, including temporal lobe epilepsy (TLE) and extratemporal/multifocal epilepsy (FLE).

Main Results:

  • Eye movements preceded contralateral head turning in 90% of seizures.
  • Head turning preceded eye movements in 67% of ipsilateral ictal head turning events.
  • A statistically significant difference (p < 0.001) was observed in the sequence of head and eye movements between ipsilateral and contralateral head turning.

Conclusions:

  • The distinct sequences of head and eye movements in ipsilateral versus contralateral ictal head turning suggest different patterns of epileptic activity spread.
  • Analysis of eye movement patterns provides an additional tool for the lateralization of the epileptogenic zone during ictal head movements.