POSTICTAL WANDERING IS COMMON AFTER TEMPORAL LOBE SEIZURES

Abstract

Some epilepsy patients in their postictal state may leave the setting of their complex partial seizures and wander either aimlessly or semipurposely. This postictal wandering (PIW) may result not only in social embarrassment but also in potentially tragic consequences if a patient wanders into a dangerous situation before regaining full consciousness. Although PIW is recognized by various names1 and has been described in patients with temporal lobe epilepsy, frontal lobe epilepsy, somnambulism, and other sleep disorders,1–4 its prevalence and localizing value have not been systematically studied. We sought to determine the frequency of PIW and whether it is preferentially associated with seizures arising from certain areas of the brain. ### Methods. Presence or absence of PIW and seizure onset localization were prospectively analyzed in 42 of 54 consecutive patients admitted to an epilepsy monitoring unit between October 2007 and May 2008 for video-EEG investigation of presumed medically refractory localization-related epilepsy. Excluded patients had nonepileptic seizures (n = 6) or no seizures (n = 4) during admission, or were found to have primary generalized epilepsy (n = 2). Simple partial seizures and secondarily generalized tonic-clonic seizures were excluded. Seizure videos were reviewed by the attending epileptologists and PIW was deemed present when in the postictal phase, after disappearance of ictal EEG patterns, patients stood up from their chairs or beds and wandered away (often …