title: Ictal and postictal semiology in patients with bilateral temporal lobe epilepsy.
abstract: Bilateral temporal lobe epilepsy is characterized by evidence of seizure onset independently in both temporal lobes. The main aim of the present study was to determine whether patients with evidence of independent bilateral temporal lobe epilepsy (biTLE) can be identified noninvasively on the basis of seizure semiology analysis. Thirteen patients with biTLE, as defined by invasive EEG, were matched with 13 patients with unilateral temporal lobe epilepsy (uniTLE). In all 26 patients, the frequency of predefined clusters of ictal and periictal signs were evaluated: ictal motor signs (IMSs), periictal motor signs (PIMSs), periictal vegetative signs (PIVSs), the frequency of early oroalimentary automatisms (EOAs), and the duration of postictal unresponsiveness (PU). Some other noninvasive and clinical data were also evaluated. A lower frequency of IMSs was noted in the group with biTLE (patients = 46.2%, seizures = 20.7%) than in the group with uniTLE (patients = 92.3%, seizures = 61.0%) (p = 0.030; p < 0.001, respectively). The individual IMS average per seizure was significantly lower in the group with biTLE (0.14; range = 0-1.0) than in the group with uniTLE (0.80; range = 0-2.6) (p = 0.003). Postictal unresponsiveness was longer than 5 min in more patients (75.0%) and seizures (42.9%) in the group with biTLE than in the group with uniTLE (patients = 30.8%, seizures = 18.6%) (p = 0.047; p = 0.002). The frequency of EOAs, PIMSs, PIVSs, and other clinical data did not differ significantly. There is a lower frequency of ictal motor signs and longer duration of postictal unresponsiveness in patients with biTLE.
authors.affiliation: Brno Epilepsy Center, First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Behavioural and Social Neuroscience Research Group, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic. Electronic address: rehulka.pavel@fnusa.cz.
authors.forename: Pavel
authors.initials: P
authors.lastname: Řehulka
authors.affiliation: Brno Epilepsy Center, First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Behavioural and Social Neuroscience Research Group, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic.
authors.forename: Irena
authors.initials: I
authors.lastname: Doležalová
authors.affiliation: Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Janoušová
authors.affiliation: Department of Neurology, Charles University in Prague, Second Faculty of Medicine, Motol University Hospital, Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Tomášek
authors.affiliation: Department of Neurology, Charles University in Prague, Second Faculty of Medicine, Motol University Hospital, Prague, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Marusič
authors.affiliation: Brno Epilepsy Center, First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Behavioural and Social Neuroscience Research Group, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic.
authors.forename: Milan
authors.initials: M
authors.lastname: Brázdil
authors.affiliation: Brno Epilepsy Center, First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Behavioural and Social Neuroscience Research Group, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic.
authors.forename: Robert
authors.initials: R
authors.lastname: Kuba
mesh_terms: D000328:Adult; D004558:Electric Stimulation / Q000295:instrumentation / Q000379:methods*; D004567:Electrodes, Implanted; D004569:Electroencephalography / Q000295:instrumentation / Q000379:methods*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D055815:Young Adult
keywords: Bilateral temporal lobe epilepsy; Bitemporal; Epilepsy; Invasive EEG; Postictal unresponsiveness; Semiology