Ictal grasping: prevalence and characteristics in seizures with different semiology.
OBJECTIVE
The aim of this study was to investigate ictal grasping (IG), defined as the act of gripping something firmly during focal epileptic seizures, and to evaluate whether it characterizes specific seizure types.


METHODS
We analyzed the video-recordings of 694 seizures in 109 consecutive candidates to epilepsy surgery. Seizures with motor manifestations (n = 511) were selected and divided into four semiological groups: (a) frontal "hyperkinetic" seizures (FHS): 30 seizures, 12 patients, (b) frontal lobe seizures (FLS) other than FHS: 228 seizures, 26 patients, (c) temporal lobe seizures (TLS): 194 seizures, 55 patients, (d) extra-frontal/extra-temporal seizures (EF/ETS): 59 seizures, 16 patients. We evaluated IG features by means of video-analysis.


RESULTS
IG was observed in 96.7% of FHS (100% of patients), with a mean latency of 3 s, and a mean prevalence of 7.9 IG per seizure, directed to a limited number of surrounding objects or body parts. In 22.4% of FLS (11.5% of patients) 1-3 prolonged IGs were present, with a mean latency of 2 s and mainly directed to a fixed external point. IG was occasionally present in TLS (10.3%, in 20% of patients) and EF/ETS (5.1%, in 12.5% of patients), with longer latencies and without any stereotypy. We did not find a reliable lateralizing value of IG.


CONCLUSIONS
Prevalence of IG in FHS was significantly higher than in other seizure groups. In FHS and FLS, IG had shorter latency and stereotyped features, characterizing an automatic ("release"?) behavior. In extra-frontal seizures, IG seemed to be an occasional purposeful movement.
Gardella
Elena
E
Department of Neurosciences, Bellaria Hospital, University of Bologna, Bologna, Italy. elena.gardella@unibo.it
Rubboli
Guido
G
Tassinari
Carlo Alberto
CA
D000328:Adult; D017668:Age of Onset; D004828:Epilepsies, Partial / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D017034:Epilepsy, Frontal Lobe / Q000175:diagnosis / Q000503:physiopathology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D011930:Reaction Time / Q000502:physiology; D012640:Seizures / Q000175:diagnosis / Q000503:physiopathology; D019956:Stereotypic Movement Disorder / Q000175:diagnosis / Q000503:physiopathology; D014743:Videotape Recording