Clinical lateralizing signs in temporal lobe complex partial seizures

Doç. Dr.Erhan Bilir, Uzm. Dr. Bijen Nazlıel

Partial seizures are seen more frequently in adults than in children. Most of these seizures are temporal lobe complex partial seizures (TLCPS). Seizures originating from frontal and other lobes are less frequent. Recently longterm video-EEG monitorization of the seizures has made it easier to understand them. Clinical lateralization studies provide several benefits in TLCPS. In addition to understanding the seizures better, it also helps in presurgical evaluations. It supports electrophysiological, radiological and neuropsychological evaluations. Surgical success rate increases when electroencephagraphical, neurophysiological and, neuropschological findings support clinical signs. Careful monitorization of the patient during a seizure helps in determining the clinical lateralization of the symptoms and motor phenomena. Useful lateralizing signs in TLCPS include unilateral hand automatisms with contralateral dystonic posturing and ictal head deviations. Ictal speech, postictal dysphasia and rarely ictal vomiting, unilateral blinking and automatisms with preserved responsiveness are also useful clinical lateralizing signs.