title: Eye movements differ between ictal ipsilateral and contralateral head turning.
abstract: OBJECTIVE
  This study evaluated the relation of head and eye movements during ictal ipsilateral and contralateral head turning in patients with focal epilepsies with regard to lateralization of the epileptogenic zone.
  
  
  METHODS
  We reviewed our database and identified patients with ictal head turning ipsilateral and contralateral to the seizure onset as defined by ictal EEG. Twenty-seven seizures of 19 consecutive patients with ipsilateral and 40 seizures of 32 patients with contralateral head turning were investigated. Twenty-four patients had temporal lobe epilepsy (TLE), and 27 patients had extratemporal or multifocal epilepsy.
  
  
  RESULTS
  Eye movement in the same direction preceded contralateral head turning in 90% (36 of 40 seizures) of the seizures, but this was the case in only 33% (9 of 27 seizures) of the ipsilateral ictal head turning. In contrary, head turning preceded the eye movements in 67% (18 of 27 seizures) of the ipsilateral ictal head turning and in only 10% of the contralateral head turning (p < 0.001). The results were similar in TLE and FLE.
  
  
  CONCLUSIONS
  The sequence of head and eye movements is different in ictal ipsilateral and contralateral head turning movements which likely reflects different spread patterns of epileptic activity associated with activation of different generators. The analysis of eye movements adds to the lateralization of ictal head movements.
authors.affiliation: Epilepsy Center, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany.
authors.forename: Leyla
authors.initials: L
authors.lastname: Baysal-Kirac
authors.affiliation: Epilepsy Center, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Rémi
authors.affiliation: Epilepsy Center, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany.
authors.forename: Anna Mira
authors.initials: AM
authors.lastname: Loesch
authors.affiliation: Epilepsy Center, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Hartl
authors.affiliation: Epilepsy Center, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Vollmar
authors.affiliation: Epilepsy Center, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany. Electronic address: noa@med.uni-muenchen.de.
authors.forename: Soheyl
authors.initials: S
authors.lastname: Noachtar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004569:Electroencephalography; D004827:Epilepsy / Q000523:psychology*; D004833:Epilepsy, Temporal Lobe / Q000523:psychology; D005133:Eye Movements; D005260:Female; D007839:Functional Laterality; D019416:Head Movements; D006801:Humans; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000523:psychology*; D055815:Young Adult
keywords: Frontal eye field; Frontal lobe epilepsy; Ictal head turning; Saccadic eye movements; Temporal lobe epilepsy; Version