Abstracts

Presurgical differentiation of patients with posterior temporal origin from those with anterior temporal origin has clinical importance because posterior lateral temporal lobe is spared in standard anterior temporal lobectomy. This study aims to determine whether there are clinico-electrical differences between anterior temporal lobe epilepsy (ALTLE) and posterior temporal lobe epilepsy (PLTLE), referring to medial temporal lobe epilepsy (MTLE).
We have analyzed the historical information, ictal semiology, ictal EEG of the TLE patients with documented favorable surgical outcome; Engel class I (seizure free), follow[ndash]up more than 1 year. LTLE was defined when discrete lesion or ictal onset zone in invasive study was located outside collateral sulcus, and sub[ndash]grouped as anterior and posterior LTLE (ALTLE and PLTLE) with reference to the line across cerebral peduncle. Total 96 seizures of 11 ALTLE, 6 PLTLE and 21 MTLE patients were reviewed.
Epigastric aura and psychic aura were less common in PLTLE than in ALTLE and MTLE although there was no statistical significance. Oroalimentary automatism (OAA) was not observed initially in PLTLE. Initial hypomotor symptom was observed frequently in PLTLE ([italic]P[/italic]=0.003). Dystonia and focal motor signs including facial twitching, clonic movement of limb were not observed in PLTLE. GTCS occurred significantly earlier in PLTLE than in ALTLE and MTLE. Ictal scalp EEG is not helpful to differentiate between ALTLE and PLTLE.
There are a number of clinical differences between ALTLE and PLTLE, although these are not sufficient to differentiate each other.