Ictal emotional expressions of children with partial epilepsy.
OBJECTIVE
To systematically analyze the lateralizing and localizing value of ictal emotional expressions (EEs) in children and compare these results with those of earlier adult studies.


METHODS
Five hundred fourteen seizures of 100 consecutive children < or = 12 years with partial (61/100 temporal lobe) epilepsy and postoperative seizure free outcome were included in the study. Video recordings of seizures were reviewed by two independent investigators blinded to the patients' clinical data.


RESULTS
Thirty-five patients produced EE at least once during their archived seizures, including fear (15), crying (12), smile (9), pain (5), happiness (3), and laughing (in one case). Emotional symptoms were divided into two groups: positive (smile, laughing, and happiness) and negative EEs (fear, crying, and pain). Emotional expressions appeared more frequently during extratemporal (49%) than temporal (26%) lobe seizures (p < 0.05). Positive EEs had an extratemporal dominance (p < 0.05), while frequency of negative EEs did not localize the seizure onset zone. Assessing their lateralizing value, positive EEs were more frequent during right-sided seizures (p < 0.05) while negative EEs did not lateralize the seizure onset zone. Frequency of EEs were independent of patients' ages, age at epilepsy onset or duration of epilepsy.


CONCLUSIONS
This is the first comprehensive childhood study showing that ictal EEs are frequent in childhood and their localizing and lateralizing properties are different from those of adults.
Fogarasi
András
A
Bethel Epilepsy Center, Bielefeld, Germany. fogarasi@bethesda.hu
Janszky
József
J
Tuxhorn
Ingrid
I
D000367:Age Factors; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000706:statistics & numerical data; D004644:Emotions / Q000502:physiology*; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000503:physiopathology; D005149:Facial Expression; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007223:Infant; D008297:Male; D008991:Monitoring, Physiologic; D011300:Preoperative Care; D014743:Videotape Recording