title: The effect of age on seizure semiology in childhood temporal lobe epilepsy.
abstract: OBJECTIVE
  Complex partial seizure is the characteristic seizure type observed in epilepsy arising from temporal lobe structures. The seizure evolution in adult patients is quite stereotyped and well characterized, manifesting initially with an aura, behavioral arrest, and oroalimentary and gestural automatism. A greater variability of semiology including motor features with tonic or myoclonic components, as well as a paucity of automatism, has been reported in young children with temporal lobe epilepsy. The aim of our study was to examine in more detail the effects of age on individual ictal features to be able to determine the critical age when lesional temporal lobe seizure semiology undergoes transition from the pediatric to the more adult-type clinical pattern.
  
  
  METHODS
  We performed a video analysis of 83 seizures from 15 children (aged 11-70 months) selected by post-temporal lobectomy seizure-free outcome, looking specifically at the motor and behavioral (nonmotor) manifestations in relation to age of the children.
  
  
  RESULTS
  All of the children younger than 42 months had seizures with early and marked motor features, which included tonic and myoclonic components and epileptic spasms. Parallel with age, the frequency of these motor components decreased, and in five of 11 children older than 3 years, motor features were totally absent. Analyzed quantitatively, we saw a linear and inverse correlation of the ratio of motor components with age at monitoring.
  
  
  CONCLUSIONS
  These findings support the hypothesis that events in brain maturation significantly affect clinical seizure semiology and may override the more typical localizing features seen in adult-type temporal lobe epilepsy. These findings are important to consider in the early diagnosis of childhood temporal lobe epilepsy.
authors.affiliation: Epilepsie-Zentrum Bethel, Bielefeld, Germany.
authors.forename: András
authors.initials: A
authors.lastname: Fogarasi
authors.forename: Hennric
authors.initials: H
authors.lastname: Jokeit
authors.forename: Eduardo
authors.initials: E
authors.lastname: Faveret
authors.forename: József
authors.initials: J
authors.lastname: Janszky
authors.forename: Ingrid
authors.initials: I
authors.lastname: Tuxhorn
mesh_terms: D000367:Age Factors; D017668:Age of Onset; D001332:Automatism / Q000175:diagnosis / Q000503:physiopathology; D001921:Brain / Q000254:growth & development / Q000503:physiopathology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004569:Electroencephalography / Q000379:methods / Q000706:statistics & numerical data; D004833:Epilepsy, Temporal Lobe / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009069:Movement Disorders / Q000175:diagnosis / Q000503:physiopathology; D014743:Videotape Recording