Localizing and lateralizing value of auditory phenomena in seizures

Area of Science:

• Neurology
• Epileptology
• Neurophysiology

Background:

• Auditory seizures (AS) are rare focal seizures.
• Traditionally associated with the temporal lobe seizure onset zone (SOZ), their precise localizing and lateralizing value remains uncertain.
• This review provides an updated description of the lateralizing and localizing value of AS.

Purpose of the Study:

• To describe the lateralizing and localizing value of auditory seizures (AS).
• To analyze the seizure onset zone (SOZ) in relation to AS semiology.
• To consolidate current knowledge on AS from existing literature.

Main Methods:

• A narrative literature review was conducted.
• Searched PubMed, Scopus, and Google Scholar for AS literature up to December 2022.
• Analyzed 174 cases (200 AS) from 70 articles, including cortical stimulation studies, case reports, and case series.

Main Results:

• The seizure onset zone (SOZ) for AS was more frequently located in the left hemisphere (62%) than the right (38%).
• Unilaterally perceived AS predominantly originated from the contralateral hemisphere (74%), but ipsilateral origins also occurred (26%).
• The SOZ was not confined to the auditory cortex or temporal lobe, with extratemporal involvement in parietal, frontal, and insular regions.

Conclusions:

• Auditory seizures are complex and crucial for identifying the seizure onset zone (SOZ).
• Limited data and varied presentations necessitate further research into AS semiology and SOZ patterns.
• The findings underscore the need for a broader consideration of SOZ locations beyond the temporal lobe for AS.