Poster Sessions

Abstract

Abstract July 9th– 11th 2007Poster SessionAdult Epileptology Abubakr A 1 , Wambacq I 2 ( 1 Seton Hall University For Graduate Medical Education, South Orange, USA , 2 Montclair State University, Montclair, USA) Purpose: Dystonic posturing of the upper limb is one of the most reliable lateralising signs in TLE. However, lower limb involvement in lateralisation of TLE is scarcely reported. Therefore we evaluated the lateralisation of ictal dystonic posturing of the lower limb in patients with TLE Method: We retrospectively reviewed the records of 83 consecutive patients with TLE admitted to the epilepsy monitoring unit at JFK hospital. Video EEG data were analysed for the presence of ictal dystonic posturing of the upper and lower limbs. Results: There were 29 males (age range 17-77 yrs) and 54 females (age range 18-88 yrs). Twenty-nine patients had right temporal lobe focus and 54 had left focus. A total of 373 seizures were reviewed. Dystonic posturing of the upper limb occurred in 17 patients (55 seizures), representing 21.5%. Lower limb ictal dystonia was present in 5 patients (20 seizures), constituting 6.1%. Ictal dystonia occurring simultaneously in both upper and lower limbs was present in 16 patients (98 seizures) representing 19.2%. All the ictal limb dystonias were contralateral to the epileptogenic hemisphere. However, in 68 clinical seizures (18.2%) the lower limbs were off the camera and therefore were not assessed. Conclusion: Lower limb ictal dystonia is present frequently (25.3% of seizures) and either occurs independently or in conjunction with upper limb ictal dystonia. In both instances it has an excellent lateralising value in TLE, which is always contralateral to the epileptogenic hemisphere.