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Does head-turning during a seizure have lateralizing or localizing significance?
Neurology
|July 1, 1984
Summary
Forced head-turning is an early seizure symptom. This study found that head-turning direction does not indicate the seizure
Area of Science:
- Neurology
- Epileptology
- Clinical Neurophysiology
Background:
- Forced lateralized head-turning is an observed clinical sign during epileptic seizures.
- Its diagnostic value in localizing seizure onset remains debated.
Purpose of the Study:
- To investigate the localizing and lateralizing significance of forced head-turning as an initial clinical manifestation of epileptic seizures.
Main Methods:
- Simultaneous video and electroencephalogram (EEG) recording of 106 epileptic seizures in 43 patients.
- Analysis of 45 ictal EEGs obtained via stereotactically implanted intracerebral electrodes.
Main Results:
- Forced head-turning occurred as the first clinical sign across various seizure onset types (frontal, temporal, unilateral diffuse, generalized).
- Ipsilateral and contralateral head-turning were equally frequent, irrespective of seizure onset location, including frontal lobe epilepsy.
Conclusions:
- Initial forced head-turning in epileptic seizures lacks specific localizing or lateralizing value.
- Clinical observation of head-turning direction alone is insufficient for determining the epileptogenic zone.