Ictal spitting in left temporal lobe epilepsy: Report of three cases

Ictal spitting in left temporal lobe epilepsy: Report of three cases

Author Caboclo, Luís Otávio Sales Ferreira Autor UNIFESP Google Scholar
Miyashira, Flávia Saori Autor UNIFESP Google Scholar
Hamad, Ana Paula Andrade Autor UNIFESP Google Scholar
Lin, Katia Autor UNIFESP Google Scholar
Carrete Junior, Henrique Autor UNIFESP Google Scholar
Sakamoto, Américo Ceiki Autor UNIFESP Google Scholar
Yacubian, Elza Márcia Targas Autor UNIFESP Google Scholar
Institution Universidade de São Paulo (USP)
Universidade Federal de São Paulo (UNIFESP)
Abstract Purpose: Ictal spitting is rarely reported in patients with epilepsy. More often it is observed in patients with temporal lobe epilepsy (TLE) and is presumed to be a lateralizing sign to language nondominant hemisphere. We report three patients with left TLE who had ictal spitting registered during prolonged video-EEG monitoring.Methods: Medical charts of all patients with medically refractory partial epilepsy submitted to prolonged video-EEG monitoring in the Epilepsy Unit at UNIFESP during a 3-year period were reviewed, in search of reports of ictal spitting. the clinical, neurophysiological and neuroimaging data of the identified patients were reviewed.Results: Among 136 patients evaluated with prolonged video-EEG monitoring, three (2.2%) presented spitting automatisms during complex partial seizures. All of them were right-handed, and had clear signs of left hippocampal sclerosis on MRI. in two patients, in all seizures in which ictal spitting was observed, EEG seizure onset was seen in the left temporal lobe. in the third patient, ictal onset with scalp electrodes was observed in the right temporal lobe, but semi-invasive monitoring with foramen ovate electrodes revealed ictal onset in the left temporal lobe, confirming false lateralization in surface records. the three patients became seizure-free following left anterior temporal lobectomy.Conclusions: Ictal spitting is a rare finding in patients with epilepsy, and may be considered a localizing sign of seizure onset in the temporal lobe. It may be observed in seizures originating from the left temporal lobe, and thus should not be considered a lateralizing sign of nondominant TLE. (C) 2006 British Epilepsy Association. Published by Elsevier B.V. All rights reserved.
Keywords ictal spitting
automatisms
temporal lobe epilepsy
Language English
Date 2006-09-01
Published in Seizure-european Journal of Epilepsy. London: W B Saunders Co Ltd, v. 15, n. 6, p. 462-467, 2006.
ISSN 1059-1311 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co Ltd
Extent 462-467
Origin http://dx.doi.org/10.1016/j.seizure.2006.05.009
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000240312500017
URI http://repositorio.unifesp.br/handle/11600/29104

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