[Clinical symptomatology of epileptic seizures of temporal origin]

Many discrepancies still exist in the description of clinical symptoms and signs attributable to a paroxysmal disorganization of temporal structures. They result from various methodological appraisals of clinical, electrophysiological and neuroradiological data concerning partial epilepsies. However a study of anatomo-electroclinical correlations in temporal seizures yield an easy pattern when the methods of elaboration, the criteria of validity and their meaning are strictly defined. An analysis of temporal seizures, recorded, filmed and described clinically in 300 patients having had a pre-surgical SEEG examination is the basis of a proposed classification of their main clinical features. The structures supposed to be ictally disorganized are, for each category, as follows: simple and complex visual and auditory hallucinations and illusions are due to a discharge beginning in the temporal-occipital or superior (posterior or anterior) temporal cortex. Memory troubles like dreamy-state are due to a simultaneous impairment of some neo-cortical areas and of Ammon's horn. Instinctive-affective troubles, like genital and sexual signs, or symptoms, emotional, mood, affective troubles seem to be linked to discharges in hippocampal and juxta-insular, internal perisylvian areas. Autonomous (cardiac, digestive, etc.) troubles are linked to a disorganization of basal limbic structures and especially of the perisylvian cortex. Motor and verbal automatisms have different meanings: only chewing is due to a discharge in the amygdalian area and in its hypothalamic efferents. Cognitive impairment is difficult to classify.(ABSTRACT TRUNCATED AT 250 WORDS)