Abstracts

RATIONALE: To determinate the physiological significance of salivation during partial seizure, we made electro-clinical correlation in patients with major ictal salivation explored by depth electrodes. METHODS: Among patients explored in our epilepsy unit for surgical treatment of their epilepsy we selected patients with an important salivation during partial seizure, who were explored with depth electrodes. Nine patients were included. The depth electrodes exploration is based on the scalp EEG-clinical correlations according to the methodology developed by Talairach and Bancaud. We also correlated salivation with the other clinical signs of the seizures and with the SEEG results in term of anatomical extent of the ictal fast discharge, and then with the surgical results. RESULTS:Salivation was observed in seizures originated in the temporal lobe (7 cases), in the frontal lobe (1 case) and in the parietal lobe (1 case) in their opercular part. When the seizures were originated in the temporal lobe, salivation was correlated with a supra sylvian opercular propagation (proved in 5 cases; in one case no electrode explored this area), in one case, no propagation is seen in the frontal lobe. It was associated with positive symptoms related with the oro-alimentary system like: mastication, swallowing, vocalization, difficulty to swallow if the origin is temporal; or like the impossibility to move the mouth and to swallow if the origin is supra sylvian. CONCLUSIONS: During partial seizure, salivation is correlated with an implication of supra sylvian opercular structures in the majority of cases (8 out of 9) like described in the litterature. In one case no supra sylvian involvement is found, the salivation may be a physiological reaction secondary to the ictal oro-alimentary activity, or may be related with the innervation of the superior salivary nucleus by fibers from the central nucleus of the amygdala.