title: Genital automatisms in childhood partial seizures.
abstract: OBJECTIVE
  To describe frequency and electroclinical characteristics as well as localizing and lateralizing value of childhood periictal genital automatisms (GAs).
  
  
  METHODS
  Five-hundred-forty-one videotaped seizures of 109 consecutive patients <12 years with refractory partial epilepsy and postoperatively seizure-free outcome were analyzed. Genital automatisms (scratching, fondling or grabbing of the genitals) were monitored by two independent investigators.
  
  
  RESULTS
  Eight (four temporal, four extratemporal) patients (7%) showed GA at least once during 20 (3.7%) seizures. Age of patients with GA was between 4.5 and 11.9 (mean 9.5+/-2.4) years and was significantly higher than the age of children without GA (p=0.006). Boys showed GAs more frequently than girls (p=0.026). Genital automatisms appeared both ictally and postictally with a mean duration of 51s. They were unilateral (completed by one hand) in 18/20 seizures and were done by the hand ipsilateral to the seizure onset zone in 16/18 cases (p=0.001). Although consciousness was preserved during GA in 3/8 patients, neither periictal urinary urge nor penile erection was associated with it.
  
  
  CONCLUSIONS
  Periictal GAs appear in school-age patients with a similar frequency to that in adults but almost lack in preschool children. Although the presence of childhood GA has neither localizing nor lateralizing value per se, the hand used for GA is more frequently ipsilateral to the seizure onset zone. The mechanisms for childhood GAs are not clear but probably different from those of adults.
authors.affiliation: Epilepsie-Zentrum Bethel, Maraklinik, D-33617 Bielefeld, Maraweg 21, Germany. fogarasi@bethesda.hu
authors.forename: András
authors.initials: A
authors.lastname: Fogarasi
authors.forename: Ingrid
authors.initials: I
authors.lastname: Tuxhorn
authors.forename: Andrea
authors.initials: A
authors.lastname: Tegzes
authors.forename: József
authors.initials: J
authors.lastname: Janszky
mesh_terms: D001332:Automatism / Q000209:etiology*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D007839:Functional Laterality / Q000502:physiology; D005832:Genital Diseases, Male / Q000209:etiology*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012640:Seizures / Q000145:classification / Q000150:complications*; D014741:Video Recording / Q000379:methods