Circling seizures

Area of Science:

• Neurology
• Epileptology

Background:

• Circling seizures are a rare but distinct ictal semiology.
• Understanding the underlying epileptic syndromes and potential lesion locations is crucial for diagnosis and management.

Purpose of the Study:

• To investigate the clinical, electroencephalographic, and radiological findings in patients experiencing circling seizures.
• To determine the association between circling seizures and different epilepsy syndromes, particularly symptomatic partial epilepsy.

Main Methods:

• Retrospective case series analysis.
• Review of clinical data, electroencephalography (EEG) findings, and neuroimaging results.
• Classification of patients into symptomatic partial, cryptogenic partial, and idiopathic generalized epilepsy groups.

Main Results:

• Twelve cases of circling seizures were analyzed.
• Four patients had symptomatic partial epilepsy, five had cryptogenic partial epilepsy, and three had idiopathic generalized epilepsy.
• In symptomatic partial epilepsy, lesions were predominantly frontal (three cases) and occasionally parietooccipital (one case).
• Turning direction during seizures did not reliably lateralize the epilepsy focus in partial epilepsy cases.

Conclusions:

• Circling seizures can occur in diverse epileptic syndromes and epilepsies.
• Symptomatic partial epilepsy presenting with circling seizures frequently involves frontal lobe lesions, with parietooccipital involvement also noted.
• The direction of head turning lacks lateralizing value in partial epilepsy with circling seizures.