Lower limb automatism in surgically treated temporal lobe epilepsy patients: Clinical and electrophysiological features. 2019

Farid Khasiyev, and F Irsel Tezer, and Serap Saygi
Hacettepe University, School of Medicine, Department of Neurology, Ankara, Turkey; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.

Lower limb automatism has not been known well in temporal lobe epilepsy (TLE) patients. This study investigated the distribution of risk factors, EEG features, and pathology types in surgically treated TLE patients. We also made a comparison of this group to surgically treated TLE patients with isolated hand automatism. Twenty TLE patients with lower limb automatism (Group 1) and 20 TLE patients with isolated hand automatisms (Group 2) of similar age/sex distribution were enrolled in our study. Male/female ratio was 14/6 in both groups. Demographical characteristics, risk factors, pathology types and EEG features were compared between two groups. 15 and 8 patients out of Group 1 (75%) and Group 2 (40%) respectively, were undergone right-sided surgery. Ipsilateral lower limb automatism was seen in 80% of patients. The age of epilepsy onset was earlier in patients with lower limb automatism (p = 0.02). There was no significant difference between the groups in terms of the risk factors and other demographical characteristics. Although, EEG features were not different, onset of ictal EEG changes in the first 10 seconds were seen less frequently in Group 1(6 vs 9 patients) (p = 0.31). Hippocampal sclerosis as a pathology type was detected in 11 patients (55%) of Group 1, whereas in 16 patients (80%) of Group 2. TLE patients with lower limb automatism have an earlier age of epilepsy onset and the onset of ictal EEG changed in the first 10 seconds of clinical seizure and pure HS pathology was rarer than in TLE patients with hand automatisms. Further studies are needed to shed more light on the pathophysiology of lower extremity automatisms in TLE patients.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004569 Electroencephalography Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. EEG,Electroencephalogram,Electroencephalograms
D004833 Epilepsy, Temporal Lobe A localization-related (focal) form of epilepsy characterized by recurrent seizures that arise from foci within the TEMPORAL LOBE, most commonly from its mesial aspect. A wide variety of psychic phenomena may be associated, including illusions, hallucinations, dyscognitive states, and affective experiences. The majority of complex partial seizures (see EPILEPSY, COMPLEX PARTIAL) originate from the temporal lobes. Temporal lobe seizures may be classified by etiology as cryptogenic, familial, or symptomatic. (From Adams et al., Principles of Neurology, 6th ed, p321). Epilepsy, Benign Psychomotor, Childhood,Benign Psychomotor Epilepsy, Childhood,Childhood Benign Psychomotor Epilepsy,Epilepsy, Lateral Temporal,Epilepsy, Uncinate,Epilepsies, Lateral Temporal,Epilepsies, Temporal Lobe,Epilepsies, Uncinate,Lateral Temporal Epilepsies,Lateral Temporal Epilepsy,Temporal Lobe Epilepsies,Temporal Lobe Epilepsy,Uncinate Epilepsies,Uncinate Epilepsy
D005260 Female Females
D006225 Hand The distal part of the arm beyond the wrist in humans and primates, that includes the palm, fingers, and thumb. Hands
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001332 Automatism Automatic, mechanical, and apparently undirected behavior which is outside of conscious control.

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