J Korean Neurol Assoc.  1996 Jun;14(2):415-424.

Clinical Utility of Postictal EEG Pattern and Semiology in Temporal Lobe Epilepsy

• Kwon OY
• Huh K
• Kim JS
• Joo IS
• Yoon SH
• Cho KG

Abstract

We investigated the postictal EEG and semiology in temporal lobe epilepsy in order to evaluate their possible clinical utility. Fifty four well lateralized seizures in 10 patients, recorded during presurgical evaluation, were analysed in regard to the frequency, pattern and location of the EEG activity (42 seizures with scalp-sphenoidal electrodes, 27 seizures with intracranial electrodes). Postictal EEG changes were very heterogenous, at best categorized to several patterns: (1) theta+delta slowing (2) attenuation (3) spike activation, among them theta+delta slowing was mosts frequently encountered. The lateralizing value of the earliest pattern was 59.3% using intracranial electrodes but only 23.3% using scalp-sphenoidal electrodes. Postictal semiology also showed a variety of behavioral manifestation such as confusion(81.5%), lip smacking(40.7%), hand automatism (18.5%). Lip smacking was more often seen following the left temporal seizure (16 out of 22, p<.05). Behavioral distinction between ictal and postictal semiology was not possible. Postictal EEG and semiology appears to be consisting of heterogenous mechanisms and wide spectrum. We feel that the clinical utility is limited.

MeSH Terms

Automatism
Electrodes
Electroencephalography*
Epilepsy, Temporal Lobe*
Hand
Humans
Lip
Seizures
Temporal Lobe*