Abstracts

Rationale: We quantitatively evaluated the localizing and lateralizing characteristics of ictal upper limb automatisms (ULA) in patients with temporal (TLE) and frontal lobe epilepsy (FLE).Methods: ULA were quantified by motion capturing in patients with TLE (n=38) and FLE (n=20). Movement speed, extent, length and duration of automatisms were analyzed ipsi- and contralaterally with regard to the lateralization of the epileptogenic lobe.Results: ULA had a larger extent (p<0.001), covered more distance (p<0.05) and were faster (p<0.001) in FLE than in TLE. In TLE, the maximum speed of ULA was higher ipsilaterally than contralaterally (median ipsilateral 173 vs. contralateral 84 pixels/s; p=0.02), whereas no significant difference was found in FLE (median ipsilateral 511 vs. contralateral 428 pixels/s). The absolute duration of automatisms was similar in TLE (median 26s) and FLE (median 27s), but the total seizure duration was significantly longer in TLE than in FLE (median 82s vs. 40s; p<0.001). The duration of ictal automatisms in relation to the total seizure duration was shorter in TLE than in FLE (median 36% vs. 63%; p<0.001). The results of the seizure-free subgroup were similar.Conclusions: Quantitative movement analysis of ULA differentiates FLE and TLE. Our data may be used in the development of three dimensional motion analysis systems that can be applied for seizure detection and presurgical evaluation of epilepsy patients.