The Facewiping and the Nosewiping Behaviour: Peri-Seizures Time Courses of a Unique Innate Pattern of Behaviour
Abstract number :
2.101
Submission category :
Year :
2001
Submission ID :
929
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
S. Meletti, MD, Neurological Sciences, Univ. of Bologna, Bellaria Hospital, Bologna, Italy; F. Rondelli, MD, Neurological Sciences, Univ. of Bologna, Bellaria Hspital, Bologna, Italy; L. Volpi, MD, Neurological Sciences, Univ. of Bologna, Bellaria Hospita
RATIONALE: Postictal nosewiping (NW) is commonly observed in mesial temporal lobe epilepsy and is highly predictive of seizure onset ipsilaterally to the hand used (Hirsch et al., 1998). Our aim was to analyze the occurrence of NW and other facewiping (FW) behaviours in the preictal and postictal period in MTLE patients.
METHODS: 45 seizures in 18 right-handed MTLE patients (12 males; mean age 31 years) were collected by means of video-EEG monitoring performed for presurgical evaluation. Videotape analysis of the 30 minutes preceding and following seizure onset (SO) was carried out to identify and quantify all hand movements directed toward the nose (nose wiping, NW) or to the mouth, eye, ear, front and scalp (face wiping, FW). Peri-seizure time histograms displaying the distribution frequency of NW, FW and NW+FW in the 60 minutes including seizures were calculated.
RESULTS: In the 60 minutes including the 45 seizures analyzed, we identified 860 hand-to-face movements: 413 (48%) were represented by NW, 447 (52%) by FW. 320 (37%) movements occurred in the 30 minutes preceding the seizure, 540 (63%) in the 30 minutes following SO. In detail, the mean number of movements per minute was: 0.3 in the interval ranging from 30 to 4 minutes before SO; 0.2 in the 4 minutes immediately preceding the SO; 1.1 in the 4 minutes following SO; 0,3 in the remaining 26 minutes. The absolute frequency distribution of the 413 NW and 447 FW showed, for both movements, a similar unimodal curve, peaking at the 2nd minute following SO for NW (34 movements), and at the 3rd minute for FW (32 movements).
CONCLUSIONS: In the 45 seizures recorded in our group of 18 patients, we observed an increase of occurrence of NW/FW movements in the 4 minutes immediately following SO. However, these movements can occur, with a lower frequency, later in the post-ictal period as well as in the pre-ictal period. Moreover, in the 4 minutes immediately following SO, we observed, instead of a specific increase of NW movements, a global increment of the movements toward the face, including either wiping of the nose or of other parts of the face. These results suggest that movements of the hands toward the face might represent a physiologic motor behavior, facilitated in the post-ictal period, and not necessarily reflex movements triggered by peri-postictal vegetative modifications.
Support: Grant MURST 40%