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Hyperkinetic seizures in patients with temporal lobe epilepsy: clinical features and outcome after temporal lobe resection.
Epilepsia 2011; 52(8):1439-46E

Abstract

PURPOSE

Temporal lobe epilepsy (TLE) is usually associated with automatisms. Hyperkinetic seizures are supposed to be unusual. Because we witnessed several patients with TLE and ictal hyperkinetic symptoms, we retrospectively assessed the number, clinical findings, and seizure outcome in such patients who had undergone temporal lobe resection.

METHODS

We reviewed medical history, video-electroencephalography (EEG) recording and neuroimaging of adult patients who underwent epilepsy surgery for TLE at the Kork Epilepsy Center over the last 20 years with a minimum postoperative follow-up of 12 months.

KEY FINDINGS

Among 294 patients who were resected exclusively in the temporal region, we identified 17 (6%) who presented with hyperkinetic semiology such as violent vocalization, complex movements of the proximal segments of the limbs, rotation of the trunk, pelvic thrusting, or early tonic or dystonic posturing. Most of the patients had a preceding aura. Ictal EEG activity was located in the corresponding temporal region, usually with a wide distribution over temporal electrodes with fast spread to unilateral frontal electrodes and to the contralateral side. Neuroimaging revealed extended lesions in the temporal lobe involving mesial and neocortical structures. Most of the patients underwent classical anterior temporal lobe resection including amygdalo-hippocampectomy. Fourteen patients (82%) became completely seizure-free (Engel class Ia). Histopathology showed mainly focal cortical dysplasia plus hippocampal sclerosis.

SIGNIFICANCE

Hyperkinetic seizure semiology may occasionally occur in patients with TLE and is, therefore, no contradiction to the hypothesis of TLE if scalp EEG patterns and neuroimaging findings correspond. The postoperative seizure outcome is favorable in such patients and not different from outcome data in classical TLE.

Authors+Show Affiliations

Kork Epilepsy Center, Kehl-Kork, Germany. astaack@epilepsiezentrum.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21569022

Citation

Staack, Anke M., et al. "Hyperkinetic Seizures in Patients With Temporal Lobe Epilepsy: Clinical Features and Outcome After Temporal Lobe Resection." Epilepsia, vol. 52, no. 8, 2011, pp. 1439-46.
Staack AM, Bilic S, Wendling AS, et al. Hyperkinetic seizures in patients with temporal lobe epilepsy: clinical features and outcome after temporal lobe resection. Epilepsia. 2011;52(8):1439-46.
Staack, A. M., Bilic, S., Wendling, A. S., Scholly, J., Kraus, U., Strobl, K., ... Steinhoff, B. J. (2011). Hyperkinetic seizures in patients with temporal lobe epilepsy: clinical features and outcome after temporal lobe resection. Epilepsia, 52(8), pp. 1439-46. doi:10.1111/j.1528-1167.2011.03100.x.
Staack AM, et al. Hyperkinetic Seizures in Patients With Temporal Lobe Epilepsy: Clinical Features and Outcome After Temporal Lobe Resection. Epilepsia. 2011;52(8):1439-46. PubMed PMID: 21569022.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hyperkinetic seizures in patients with temporal lobe epilepsy: clinical features and outcome after temporal lobe resection. AU - Staack,Anke M, AU - Bilic,Sofia, AU - Wendling,Anne-Sophie, AU - Scholly,Julia, AU - Kraus,Uwe, AU - Strobl,Karl, AU - Bodin,Frédéric, AU - Zentner,Josef, AU - Steinhoff,Bernhard J, Y1 - 2011/05/13/ PY - 2011/5/17/entrez PY - 2011/5/17/pubmed PY - 2012/3/17/medline SP - 1439 EP - 46 JF - Epilepsia JO - Epilepsia VL - 52 IS - 8 N2 - PURPOSE: Temporal lobe epilepsy (TLE) is usually associated with automatisms. Hyperkinetic seizures are supposed to be unusual. Because we witnessed several patients with TLE and ictal hyperkinetic symptoms, we retrospectively assessed the number, clinical findings, and seizure outcome in such patients who had undergone temporal lobe resection. METHODS: We reviewed medical history, video-electroencephalography (EEG) recording and neuroimaging of adult patients who underwent epilepsy surgery for TLE at the Kork Epilepsy Center over the last 20 years with a minimum postoperative follow-up of 12 months. KEY FINDINGS: Among 294 patients who were resected exclusively in the temporal region, we identified 17 (6%) who presented with hyperkinetic semiology such as violent vocalization, complex movements of the proximal segments of the limbs, rotation of the trunk, pelvic thrusting, or early tonic or dystonic posturing. Most of the patients had a preceding aura. Ictal EEG activity was located in the corresponding temporal region, usually with a wide distribution over temporal electrodes with fast spread to unilateral frontal electrodes and to the contralateral side. Neuroimaging revealed extended lesions in the temporal lobe involving mesial and neocortical structures. Most of the patients underwent classical anterior temporal lobe resection including amygdalo-hippocampectomy. Fourteen patients (82%) became completely seizure-free (Engel class Ia). Histopathology showed mainly focal cortical dysplasia plus hippocampal sclerosis. SIGNIFICANCE: Hyperkinetic seizure semiology may occasionally occur in patients with TLE and is, therefore, no contradiction to the hypothesis of TLE if scalp EEG patterns and neuroimaging findings correspond. The postoperative seizure outcome is favorable in such patients and not different from outcome data in classical TLE. SN - 1528-1167 UR - https://www.unboundmedicine.com/medline/citation/21569022/Hyperkinetic_seizures_in_patients_with_temporal_lobe_epilepsy:_clinical_features_and_outcome_after_temporal_lobe_resection_ L2 - https://doi.org/10.1111/j.1528-1167.2011.03100.x DB - PRIME DP - Unbound Medicine ER -