Ictal automatisms with preserved responsiveness in a patient with left mesial temporal lobe epilepsy.
OBJECTIVE
To describe the possible mechanism of ictal automatisms with preserved responsiveness (APRs) in a patient with left mesial temporal lobe epilepsy, which had not been reported previously.


METHODS
Ictal EEGs recorded from bilateral foramen ovale electrodes with scalp-sphenoidal electrodes were analyzed in respect to the ictal semiology.


RESULTS
The patient had a right hemispheric language dominance in the dextral. Electroclinical analysis revealed that the onset of oroalimentary automatisms coincided with the involvement of the left mesial and lateral temporal structures by spreading ictal discharges. The ictal discharge spreading was limited to the ipsilateral hemisphere throughout the seizure, which explained the intact consciousness and preserved responsiveness of the patient.


CONCLUSIONS
This case suggests that APRs take place in seizures originating from the nondominant temporal lobe, during which ipsilateral mesial and lateral temporal structures are diffusely involved without spreading to the contralateral side.
Park
S A
SA
Departments of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Heo
K
K
Koh
R
R
Chang
J W
JW
Lee
B I
BI
D000293:Adolescent; D001332:Automatism / Q000175:diagnosis* / Q000503:physiopathology; D003243:Consciousness / Q000502:physiology*; D004569:Electroencephalography / Q000706:statistics & numerical data*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008991:Monitoring, Physiologic; D013702:Temporal Lobe / Q000503:physiopathology*; D014743:Videotape Recording