title: Ictal vomiting in a left hemisphere language-dominant patient with left-sided temporal lobe epilepsy.
abstract: Ictal vomiting in patients with focal epilepsy has mostly been associated with an epileptogenic zone in the non-language-dominant hemisphere. Here we present the case of a left hemisphere language-dominant patient suffering from typical mesial temporal lobe epilepsy with histologically proven hippocampal sclerosis and ictal vomiting during complex partial seizures. He became seizure-free after selective left-sided amygdalohippocampectomy. This case implies that ictal vomiting may not necessitate invasive electrophysiological exploration of left hemisphere language-dominant patients with temporal lobe epilepsy if surface EEG and MRI indicate a left-sided epileptogenic zone. It thus corroborates that with concordant imaging and neurophysiological data, clinical signs become less valuable.
authors.affiliation: Department of Epileptology and EEG, University Hospital of Zürich, Frauenklinikstrasse 26, CH-8091 Zürich, Switzerland. kschindler@smile.ch
authors.forename: Kaspar
authors.initials: K
authors.lastname: Schindler
authors.forename: Heinz Gregor
authors.initials: HG
authors.lastname: Wieser
mesh_terms: D000328:Adult; D000679:Amygdala / Q000601:surgery; D004292:Dominance, Cerebral; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology* / Q000601:surgery; D006624:Hippocampus / Q000601:surgery; D006801:Humans; D007802:Language; D008279:Magnetic Resonance Imaging; D008297:Male; D011300:Preoperative Care; D014839:Vomiting