title: Ictal smile lateralizes to the right hemisphere in childhood epilepsy.
abstract: OBJECTIVE
  To analyze the localizing and lateralizing value of ictal smile (IS) in childhood epilepsy.
  
  
  METHODS
  Incidence of IS in 309 videotaped seizures of 114 consecutive patients younger than 12 years with refractory frontal, temporal, or posterior cortex epilepsy were assessed.
  
  
  RESULTS
  Among patients with right-sided epileptogenic zone, 12 (21%) of 57 had IS, whereas in patients with left-sided epilepsy, IS occurred only in one patient (1.8%; p < 0.01, chi(2) test). The incidence of IS was 11%, 3%, and 26% in the frontal, temporal, and posterior cortex subgroups, respectively. Logistic regression revealed that the localization of the epileptogenic region in the posterior cortex (p < 0.01), focal cortical dysplasia etiology (p = 0.012), and right-sided lateralization (p = 0.025) were independently associated with the presence of IS.
  
  
  CONCLUSIONS
  Childhood IS lateralizes to the right hemisphere and localizes more frequently in the posterior cortex epilepsy.
authors.affiliation: Epilepsie-Zentrum Bethel, Bielefeld, Maraweg, Germany.
authors.forename: András
authors.initials: A
authors.lastname: Fogarasi
authors.forename: József
authors.initials: J
authors.lastname: Janszky
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Siegler
authors.forename: Ingrid
authors.initials: I
authors.lastname: Tuxhorn
mesh_terms: D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000706:statistics & numerical data; D004827:Epilepsy / Q000175:diagnosis* / Q000503:physiopathology; D017034:Epilepsy, Frontal Lobe / Q000175:diagnosis / Q000503:physiopathology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008297:Male; D012904:Smiling / Q000502:physiology*; D014743:Videotape Recording