Upper limb automatisms differ quantitatively in temporal and frontal lobe epilepsies

• Published in: Epilepsy & behavior Vol. 27; no. 2; pp. 404 - 408
• Main Authors: Silva Cunha, João P, Rémi, Jan, Vollmar, Christian, Fernandes, José M, Gonzalez-Victores, Jose A, Noachtar, Soheyl
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2013
• Subjects: Automatism - diagnosis; Automatism - etiology; Electroencephalography; Epilepsy, Frontal Lobe - complications; Epilepsy, Temporal Lobe - complications; Epileptic automatism; Female; Frontal lobe epilepsy; Functional Laterality - physiology; Humans; Lateralization; Male; Movement - physiology; Neurology; Psychomotor Performance; Quantitative movement analysis; Statistics, Nonparametric; Temporal lobe epilepsy; Tomography, Emission-Computed, Single-Photon; Upper Extremity - physiopathology; Frontal lobe epilepsy; Temporal lobe epilepsy; Epileptic automatism; Lateralization; Quantitative movement analysis
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2013.02.026

Abstract We quantitatively evaluated the localizing and lateralizing characteristics of ictal upper limb automatisms (ULAs) in patients with temporal lobe epilepsy (TLE; n = 38) and frontal lobe epilepsy (FLE; n = 20). Movement speed, extent, length, and duration of ULAs were quantitatively analyzed with motion capturing techniques. Upper limb automatisms had a larger extent (p < 0.001), covered more distance (p < 0.05), and were faster (p < 0.001) in FLE than in TLE. In TLE, the maximum speed of ULAs was higher ipsilaterally than contralaterally (173 vs. 84 pixels/s; p = 0.02), with no significant difference in FLE (511 vs. 428). The duration of ictal automatisms in relation to the total seizure duration was shorter in TLE than in FLE (median 36% vs. 63%; p < 0.001), with no difference in the absolute duration (26 s vs. 27 s). These results demonstrate that quantitative movement analysis of ULAs differentiates FLE from TLE, which may aid in the localization of the epileptogenic zone.