Ictal smile lateralizes to the right hemisphere in childhood epilepsy.
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.
Fogarasi
András
A
Epilepsie-Zentrum Bethel, Bielefeld, Maraweg, Germany.
Janszky
József
J
Siegler
Zsuzsanna
Z
Tuxhorn
Ingrid
I
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