Surgical treatment of hypermotor seizures originating from the temporal lobe.
OBJECTIVE
To describe the characteristics of electroclinical manifestations in patients with hypermotor seizures (HMSs) originating from the temporal lobe.


METHODS
We retrospectively reviewed the data of patients who underwent surgical treatments for seizure to identify patients with HMSs of temporal origin. We systematically reviewed patient seizure histories, imaging reports, video-EEG monitoring data, operative records and pathological findings.


RESULTS
Eight of the 9 patients reported auras. The ictal behavior included marked agitation in 5 patients and mild agitation in 4 patients. All of the 9 patients exhibited stiffness or dystonia of the upper limb or contralateral limbs during ictus. Seven of the 9 patients completed intracranial recording and at least 3 seizures were recorded for each patient. The intracranial recordings showed ictal activity originating from mesial temporal lobe in 6 patients and the lateral temporal lobe in 1 patient. The time interval of ictal propagation from the temporal to frontal lobe was 15.0 ± 8.3 s. While the time interval from EEG origination to the beginning of hypermotor behavior was 21.0 ± 8.1 s. Brain MRIs revealed hippocampal sclerosis in 3, neoplastic lesion in 1, and normal images in the remaining 5 patients. Patients were followed for 1-5 years after the anterior temporal lobectomy; 7 patients remained seizure-free throughout follow-up.


CONCLUSIONS
Some HMSs can originate from the temporal lobe. In carefully selected patients, surgical resection may lead to good outcomes.
Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, China.
Tao
T
Yu
Guojun
G
Zhang
Yuping
Y
Wang
Lixin
L
Cai
Xiaoxia
X
Zhou
Wei
W
Du
Yongjie
Y
Li
D000293:Adolescent; D000328:Adult; D038481:Anterior Temporal Lobectomy; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D012640:Seizures / Q000601:surgery*; D013702:Temporal Lobe / Q000601:surgery*; D016896:Treatment Outcome
Epilepsy surgery; Hypermotor seizure; Temporal lobe