Mesial temporal sclerosis epilepsy: clinical and pathophysiological features

Jorge, Carmen Lisa

doi:10.1590/s0004-282x1996000300030

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“…UDP occurred in 16% of the seizures, a less expressive result to that observed in other studies 6,8,9,26 . This feature was always contralateral to the EA matching with other reports 6,8,28,29 and confirming its lateralizatory value. Semah et al 27 , however, observed UDP ipsilateral to the EA in 100% of the neocortical seizures and contralateral dystonia of 96% in mesial seizures.…”

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confidence: 90%

Clinical and eeg analysis of mesial and lateral temporal lobe seizures

Dantas¹,

Yacubian

Jorge³

et al. 1998

Arq. Neuro-Psiquiatr.

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-The analysis of the temporal lobe seizures through video-EEG systems shows that they often consist of a sequence of clinical and EEG features which may suggest the localization and the lateralization of the epileptogenic lobe. We analyzed clinical and EEG features of 50 temporal lobe seizures which were separated in group 1 with 25 patients (related to mesial temporal sclerosis) and group 2 with 25 patients (other neocortical temporal lesions). Among the auras, the epigastric type was the most frequent and predominated in group 1. There were differences between the two groups, considering dystonic and tonic posturing and versive head and eye movements. Dystonic posturing was always contralateral to the ictal onset and was considered the most useful lateralizing clinical feature. Ictal speech, spitting and blinking automatisms, prolonged disorientation for place and a greatest percentage of postictal language preservation occurred in right temporal seizures. Postictal aphasia and global disorientation predominated in left temporal seizures. EEG was important for lateralizing the epileptogenic lobe, specially considering rhythmic ictal activity and postictal findings.KEY WORDS: temporal lobe epilepsy, complex partial seizures, video-EEG.Análise clínica e eletrencefalográfica de crises epilépticas temporais de origem mesial e lateral RESUMO -As crises epilépticas do lobo temporal tendem a seguir uma sequência previsível de eventos clínicos e eletrencefalográficos, cuja análise, preferencialmente através de sistemas de vídeo-EEG, sugere a localização e a lateralização do lobo epileptogênico. Para este estudo, foram analisadas 50 crises epilépticas do lobo temporal, do ponto de vista clínico e eletrencefalográfico, sendo 25 relacionadas a esclerose mesial (grupo 1) e 25 a patologias neocorticais (grupo 2). Auras abdominais foram as mais frequentes, predominando no grupo 1. Houve diferenças entre os dois grupos, quanto à instalação e duração da postura distônica, à postura tônica e à versão oculocefálica. Postura distônica unilateral foi o mais importante fenômeno clínico lateralizatório, sempre contralateral à área epileptogênica. Verbalização crítica, automatismo de cuspir, piscamento palpebral bilateral, desorientação espacial prolongada e maior percentual de preservação da linguagem no período pós-crítico foram relacionados a crises temporais direitas. Afasia pós-crítica e desorientação global, a crises temporais esquerdas. O EEG teve importante acurácia lateralizatória em ambos os grupos, especialmente quanto à atividade crítica rítmica e achados pós-críticos. PALAVRAS-CHAVE: epilepsia do lobo temporal, crises parciais complexas, vídeo-EEG.According to the International Classification of Epilepsies and Epileptic Syndromes 1 , these can be divided in partial, generalized, epilepsies and syndromes undetermined whether focal or generalized and special syndromes. Temporal lobe epilepsy (TLE) is responsible for 60% of all the partial epileptic seizures 2 and it has been extensively studied clinically, electr...

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