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Epileptic Disorders

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Ictal kissing: a release phenomenon in non-dominant temporal lobe epilepsy Volume 12, issue 4, December 2010

Figure 1 (Patient 1). MEG localized the inter-ictal epileptiform activity in the right basal mid-temporal lobe with anterior propagation. The left panels show the recorded MEG activity. Left upper panel: MEG channels; left lower panel: magnetic field distribution map. The right panels demonstrate the magnetic source co-registered to the patient's MRI. Right upper panel: three-dimensional head model; right lower panel: coronal high volume MRI acquisition. Note the anterior propagation of the magnetic field on the 3D model and the coronal MRI (courtesy of Dr John Ebersole).

Figure 2 (Patient 2). A sudden arousal from drowsiness is seen, followed within two seconds by a rhythmic right temporal theta pattern. Ten seconds after onset, a repetitive EMG artefact is seen over the left hemispheric electrodes coinciding clinically with oral and manual automatisms. A similar electrographic onset was seen in all of her six recorded seizures.

Figure 3 (Patient 3). Clinical onset consisted of a sudden kiss, followed by circular, semi-purposeful hand movements (see video sequence 3). The blue marker annotates the moment of the kiss with the associated EMG artefact. EEG seizure onset is seen over the right temporal region 1.5 seconds later. Evolution of ictal theta activity is noted 10 seconds later over the left temporal chain as well. This rapid spread of ictal activity to the left side was seen for all her six recorded seizures.