title: Lateralizing significance of quantitative analysis of head movements before secondary generalization of seizures of patients with temporal lobe epilepsy.
abstract: OBJECTIVE
  To quantitatively evaluate the lateralizing significance of ictal head movements of patients with temporal lobe epilepsy (TLE).
  
  
  METHODS
  We investigated EEG-video recorded seizures of patients with TLE, in which the camera position was perpendicular to the head facing the camera in an upright position and bilateral head movement was recorded. Thirty-eight seizures (31 patients) with head movement in both directions were investigated. Ipsilateral and contralateral head movements were defined according to ictal EEG. Head movements were quantified by selecting the movement of the nose in relation to a defined point on the thorax (25/s) in a defined plane facing the camera. The duration of the head version was determined independently of the camera angle. The angle, duration, and angular speed of the head movements were computed and inter and intrasubject analyses were performed (Wilcoxon rank sum).
  
  
  RESULTS
  Ipsilateral movement always preceded contralateral movement. The positive predictive value was 100% for movement in both directions. The duration of contralateral head version was significantly longer than ipsilateral head movement (6.4 +/- 4.1 s vs. 3.9 +/- 3.1 s, p<0.001). The angular speed of both movements was similar (15.5 +/- 12.1 deg/s vs. 17.3 +/- 13.0 deg/s).
  
  
  CONCLUSIONS
  The quantitative analysis shows the importance of sequence in the seizure's evolution and duration, but not angular speed for correct lateralization of versive head movement. This quantitative method shows the high lateralizing value of ictal lateral head movements in TLE.
authors.affiliation: Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany.
authors.forename: Rebecca
authors.initials: R
authors.lastname: O'Dwyer
authors.forename: Joao P
authors.initials: JP
authors.lastname: Silva Cunha
authors.forename: Christian
authors.initials: C
authors.lastname: Vollmar
authors.forename: Cordula
authors.initials: C
authors.lastname: Mauerer
authors.forename: Berend
authors.initials: B
authors.lastname: Feddersen
authors.forename: Richard C
authors.initials: RC
authors.lastname: Burgess
authors.forename: Alois
authors.initials: A
authors.lastname: Ebner
authors.forename: Soheyl
authors.initials: S
authors.lastname: Noachtar
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004569:Electroencephalography / Q000706:statistics & numerical data; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006257:Head / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012640:Seizures / Q000175:diagnosis / Q000503:physiopathology*; D014743:Videotape Recording / Q000379:methods / Q000706:statistics & numerical data