title: Age-dependent seizure semiology in temporal lobe epilepsy.
abstract: OBJECTIVE
  To examine the effects of age on different aspects of temporal lobe seizure semiology.
  
  
  METHODS
  We performed a video analysis of 605 archived seizures from 155 consecutive patients (age 10 months to 49 years) selected by seizure freedom after temporal lobectomy. Eighty patients had hippocampal sclerosis (HS). Beside semiological seizure classification, we assessed age dependency of several axes of seizure semiology: (1) aura, (2) number of different lateralizing signs, occurrence of ictal (3) emotional signs, (4) autonomic symptoms, (5) automatisms, and (6) secondary generalization as well as (7) the ratio of motor seizure components.
  
  
  RESULTS
  From the 155 patients, 117 reported aura, 39 had ictal emotional signs, 51 had autonomic symptoms, 130 presented automatisms, while 18 patients showed secondary generalization at least once during their seizures. Altogether 369 (median: 2/patient) different lateralizing signs were recorded. Frequency of HS (p < 0.001), ictal automatisms (p < 0.001), secondary generalization (p = 0.014), number of different lateralizing signs (p < 0.001) increased while the ratio of motor seizure component (p = 0.007) decreased by age. Auras, emotional symptoms, and autonomic signs occurred independently of patients' ages. Hippocampal sclerosis adjusted linear models revealed that the frequency of automatisms and secondarily generalized seizures as well as the number of different lateralizing signs are HS-independent significant variables.
  
  
  CONCLUSIONS
  Our findings support that brain maturation significantly influences the evolution of some important aspects (motor seizures, lateralizing signs) of temporal lobe seizure semiology. Conversely, other aspects (aura, emotional, and autonomic signs) are independent of the maturation process. This is the first report investigating age dependency of epileptic seizure semiology comparing all age groups.
authors.affiliation: Epilepsy Center, Bethesda Children's Hospital, Budapest, HungaryBethel Epilepsy Center, Bielefeld, GermanyEpilepsy Center, National Institute of Psychiatry and Neurology, Budapest, HungaryDepartment of Neurology, University of Pécs, Pécs, HungaryDepartment of Public Health, Karolinska Institute, Stockholm, Sweden, and Department of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: András
authors.initials: A
authors.lastname: Fogarasi
authors.affiliation: Epilepsy Center, Bethesda Children's Hospital, Budapest, HungaryBethel Epilepsy Center, Bielefeld, GermanyEpilepsy Center, National Institute of Psychiatry and Neurology, Budapest, HungaryDepartment of Neurology, University of Pécs, Pécs, HungaryDepartment of Public Health, Karolinska Institute, Stockholm, Sweden, and Department of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Tuxhorn
authors.affiliation: Epilepsy Center, Bethesda Children's Hospital, Budapest, HungaryBethel Epilepsy Center, Bielefeld, GermanyEpilepsy Center, National Institute of Psychiatry and Neurology, Budapest, HungaryDepartment of Neurology, University of Pécs, Pécs, HungaryDepartment of Public Health, Karolinska Institute, Stockholm, Sweden, and Department of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: József
authors.initials: J
authors.lastname: Janszky
authors.affiliation: Epilepsy Center, Bethesda Children's Hospital, Budapest, HungaryBethel Epilepsy Center, Bielefeld, GermanyEpilepsy Center, National Institute of Psychiatry and Neurology, Budapest, HungaryDepartment of Neurology, University of Pécs, Pécs, HungaryDepartment of Public Health, Karolinska Institute, Stockholm, Sweden, and Department of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Imre
authors.initials: I
authors.lastname: Janszky
authors.affiliation: Epilepsy Center, Bethesda Children's Hospital, Budapest, HungaryBethel Epilepsy Center, Bielefeld, GermanyEpilepsy Center, National Institute of Psychiatry and Neurology, Budapest, HungaryDepartment of Neurology, University of Pécs, Pécs, HungaryDepartment of Public Health, Karolinska Institute, Stockholm, Sweden, and Department of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: György
authors.initials: G
authors.lastname: Rásonyi
authors.affiliation: Epilepsy Center, Bethesda Children's Hospital, Budapest, HungaryBethel Epilepsy Center, Bielefeld, GermanyEpilepsy Center, National Institute of Psychiatry and Neurology, Budapest, HungaryDepartment of Neurology, University of Pécs, Pécs, HungaryDepartment of Public Health, Karolinska Institute, Stockholm, Sweden, and Department of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Anna
authors.initials: A
authors.lastname: Kelemen
authors.affiliation: Epilepsy Center, Bethesda Children's Hospital, Budapest, HungaryBethel Epilepsy Center, Bielefeld, GermanyEpilepsy Center, National Institute of Psychiatry and Neurology, Budapest, HungaryDepartment of Neurology, University of Pécs, Pécs, HungaryDepartment of Public Health, Karolinska Institute, Stockholm, Sweden, and Department of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Halász
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D038481:Anterior Temporal Lobectomy; D001332:Automatism / Q000175:diagnosis / Q000453:epidemiology; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011300:Preoperative Care; D015995:Prevalence; D012598:Sclerosis / Q000473:pathology