Localizing and lateralizing value of behavioral change in childhood partial seizures.
OBJECTIVE
To describe clinical characteristics as well as localizing and lateralizing value of behavioral change (BC) at the onset of childhood seizures.


METHODS
Five hundred forty-one videotaped seizures of 109 consecutive patients < or = 12 years with partial epilepsy and postoperatively seizure-free outcome were analyzed. Behavioral change (the first clinical feature of a certain seizure with a sudden change in the child's behavior) was evaluated by two independent investigators.


RESULTS
Thirty-three (30%) patients showed BC at least once during their seizures. Behavioral changes appeared in arrestive form in 19 and with affective activities in 18 children; four patients produced both kinds of BCs, separately. Arrest-type BC happened in 16 of 50 children with right- and 3 of 59 patients with left-sided seizure onset zone (p < 0.001). Affective-type BC was observed in 17 of 67 temporal lobe epilepsy patients while it happened in only 1 of 42 children with extratemporal lobe epilepsy (p = 0.001).


CONCLUSIONS
Arrest-type BC lateralizes to the right hemisphere, while affective-type BC localizes to the temporal lobe in childhood partial seizures. Type of BCs can add important information to the presurgical evaluation of young children with refractory partial epilepsy.
Fogarasi
András
A
Epilepsie-Zentrum Bethel, Bielefeld, Germany.
Janszky
József
J
Tuxhorn
Ingrid
I
D017677:Age Distribution; D000367:Age Factors; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology*; D002648:Child; D002652:Child Behavior / Q000502:physiology; D002675:Child, Preschool; D018572:Disease-Free Survival; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000502:physiology; D008297:Male; D009043:Motor Activity / Q000502:physiology; D011300:Preoperative Care; D014743:Videotape Recording