title: Ictal kissing: Electroclinical features of an unusual ictal phenomenon.
abstract: OBJECTIVE
  The study aimed to describe the electroclinical features of ictal kissing, an unusual behavior that may occur during focal seizures.
  
  
  METHODS
  Twenty-five patients collected from four epilepsy centers and previously published reports were reviewed for their demographic, clinical, and electrophysiological features.
  
  
  RESULTS
  Sixteen of 25 patients were female. The mean age was 32.9 years (9.9-51 years) and the average age at seizure onset was 14.5 years. All seizures were localized to the temporal lobe (TL) and lateralized to right side in 17 patients, left side in 2 patients, and unclear in 6 patients. A total of 55 ictal video electroencephalograms (EEGs) were analyzed. There were other symptoms such as speaking, spitting, hugging, and oral and upper-extremity automatisms along with different types of ictal kissing behavior during the seizures. The median duration of all seizures was 106.7±73.73s. Kissing occurred at a median time of 71s (1-95s) after the onset of seizure, and ictal epileptiform discharges usually involved TL during kissing episode.
  
  
  CONCLUSIONS
  Ictal kissing is mainly associated with right TL and female gender, although association with left TL may also occurs, possibly related to the circuits involving temporo-insular structures.
authors.affiliation: Department of Neurology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey. Electronic address: cigdem.ozkara@gmail.com.
authors.forename: Çiğdem
authors.initials: Ç
authors.lastname: Özkara
authors.affiliation: Department of Neurosurgery, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Taşkıran
authors.affiliation: Department of Neurology, Medical Faculty, Gazi University, Ankara, Turkey.
authors.forename: İrem Yıldırım
authors.initials: İY
authors.lastname: Çarpraz
authors.affiliation: Department of Neurology, Medical Faculty, Gazi University, Ankara, Turkey.
authors.forename: Erhan
authors.initials: E
authors.lastname: Bilir
authors.affiliation: Department of Neurology, Medical Faculty, Uludağ University, Bursa, Turkey.
authors.forename: Aylin Bican
authors.initials: AB
authors.lastname: Demir
authors.affiliation: Department of Neurology, Medical Faculty, Uludağ University, Bursa, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Bora
authors.affiliation: Department of Neurology, Medical Faculty, Ege University, Izmir, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Aydoğdu
authors.affiliation: Department of Neurology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Şakir
authors.initials: Ş
authors.lastname: Delil
authors.affiliation: Centre Hospitalier Sainte Anne, Paris, France.
authors.forename: Francine
authors.initials: F
authors.lastname: Chassoux
mesh_terms: D000293:Adolescent; D000328:Adult; D001332:Automatism / Q000503:physiopathology* / Q000523:psychology; D002648:Child; D000069279:Drug Resistant Epilepsy / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000503:physiopathology; D012640:Seizures / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology; D012737:Sex Factors; D012919:Social Behavior; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055815:Young Adult
keywords: Automatism; Emotion; Epilepsy; Ictal kissing; Limbic sytem; Temporal lobe