title: Factors contributing to clinical seizure lateralization in patients with mesial temporal lobe epilepsy.
abstract: Clinical seizure semiology can provide important information on the lateralization of the epileptogenic zone. We investigated factors associated with clinical seizure lateralization in patients with pathologically proven mesial temporal sclerosis. We reviewed 243 seizures of 58 patients. Clinical lateralization was possible in 155 (63.8%) of 243 seizures. Lateralization was correct in 144 (92.9%) of 155 lateralized seizures. Logistic regression analysis showed that age at onset (p = 0.001; odds ra tio = 1.089, 95% confidence interval = 1.035-1.145) and the contralateral propagation pattern of ictal discharges (p = 0.001; odds ratio = 3.544, 95% confidence interval = 1.723-7.289) correlated with clinical seizure lateralization. The patient group with clinically lateralized seizures had a younger age at onset of habitual seizures compared to the clinically nonlateralized group (11.1 +/- 6.3 vs. 15.6 +/- 8.4 years; p < 0.001). Of seizures without bitemporal asynchrony or switch of lateralization, 70.7% were clinically lateralized compared with only 46.4% of seizures with asynchrony or lateralization switch. The present results suggest that the age of epilepsy onset and the ictal scalp EEG propagation pattern affect clinical seizure lateralization in patients with mesial temporal sclerosis.
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Suk-Yun
authors.initials: SY
authors.lastname: Kang
authors.forename: Sang-Ahm
authors.initials: SA
authors.lastname: Lee
authors.forename: Soo Bin
authors.initials: SB
authors.lastname: Yim
authors.forename: Young Min
authors.initials: YM
authors.lastname: Lim
authors.forename: Joong Koo
authors.initials: JK
authors.lastname: Kang
authors.forename: Jung Kyo
authors.initials: JK
authors.lastname: Lee
mesh_terms: D000328:Adult; D017668:Age of Onset; D000704:Analysis of Variance; D001767:Blinking / Q000502:physiology; D016001:Confidence Intervals; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012598:Sclerosis / Q000503:physiopathology; D012640:Seizures / Q000503:physiopathology*