title: Versive seizures in occipital lobe epilepsy: lateralizing value and pathophysiology.
abstract: To clarify the value of versive seizures in lateralizing and localizing the epileptogenic zone in patients with occipital lobe epilepsy, we studied 13 occipital lobe epilepsy patients with at least one versive seizure recorded during preoperative noninvasive video-EEG monitoring, who underwent occipital lobe resection, and were followed postoperatively for more than 2 years with Engel's class I outcome. The videotaped versive seizures were analyzed to compare the direction of version and the side of surgical resection in each patient. Moreover, we examined other motor symptoms (partial somatomotor manifestations such as tonic and/or clonic movements of face and/or limbs, automatisms, and eyelid blinking) associated with version. Forty-nine versive seizures were analyzed. The direction of version was always contralateral to the side of resection except in one patient. Among accompanying motor symptoms, partial somatomotor manifestations were observed in only five patients. In conclusion, versive seizure is a reliable lateralizing sign indicating contralateral epileptogenic zone in occipital lobe epilepsy. Since versive seizures were accompanied by partial somatomotor manifestations in less than half of the patients, it is suggested that the mechanism of version in occipital lobe epilepsy is different from that in frontal lobe epilepsy.
authors: National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Aoi-ku, Shizuoka, Japan. n-usui@szec.hosp.go.jp
authors: Naotaka
authors: N
authors: Usui
authors: Tadahiro
authors: T
authors: Mihara
authors: Koichi
authors: K
authors: Baba
authors: Kazumi
authors: K
authors: Matsuda
authors: Takayasu
authors: T
authors: Tottori
authors: Shuichi
authors: S
authors: Umeoka
authors: Akihiko
authors: A
authors: Kondo
authors: Fumihiro
authors: F
authors: Nakamura
authors: Kiyohito
authors: K
authors: Terada
authors: Keiko
authors: K
authors: Usui
authors: Yushi
authors: Y
authors: Inoue
mesh_terms: D000293:Adolescent; D000328:Adult; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D020938:Epilepsy, Partial, Motor / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D005133:Eye Movements / Q000502:physiology; D007839:Functional Laterality / Q000502:physiology*; D006212:Hallucinations / Q000503:physiopathology; D019416:Head Movements / Q000502:physiology; D006801:Humans; D009778:Occipital Lobe / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D014741:Video Recording; D055815:Young Adult