Abstracts

Rationale: The main purpose of our study was to establish the incidence and lateralizing value of periictal bed leaving (PBL) in patients suffering from temporal lobe epilepsy (TLE). Methods: We reviewed a total of 97 patients (59 men and 38 women). All patients underwent a successful epilepsy surgery procedure and were classified as Engel I at the 2-year follow-up visit. Histopathological examination revealed hippocampal sclerosis (TLE-HS) in 60 patients and other lesions in 34 patients (TLE-oth); 3 patients had no lesions. We reviewed 380 seizures (234 seizures in patients with TLE-HS and 146 seizures in patients with TLE-oth). Of those, 202 seizures arose from the right temporal lobe and 178 from the left temporal lobe. PBL was defined as lateralized leaving of the bed occurring during the seizure or up to 3 minutes after the end of the seizure. Fisher s exact test was used for the statistical evaluation of categorical variables. A P value < 0.05 was considered as statistically significant. Results: PBL was observed in 27 out of 97 patients (27.8%), in 44 out of 380 seizures (11.6%). PBL was more frequently present in patients with TLE-HS than in those with TLE-oth (33% vs.18.9%; p=0.095). In total, PBL ipsilateral to the seizure onset zone was observed in 62.9% of patients and 68.2% seizures (p=0.102 and 0.043). In patients with TLE-HS, PLB was present ipsilateral to the seizure onset in 80% of patients and 83.2% seizures (p=0.006 and 0.002). Similarly, in patients with TLE-oth, PLB was present ipsilateral to the seizure onset in 14.3% of patients and 35.7% seizures (p=0.577 and 0.413). There were no differences in the incidence and lateralizing value between patients with left-sided TLE and those with right-sided TLE. Conclusions: PBL is a relatively frequent periictal sign in patients with TLE. In patients with TLE-HS, the side of PBL lateralizes the seizure onset zone to the ipsilateral temporal lobe. Supported by MSMT CR research project: MSM0021622404