Iktalni a postiktalni lateralizacni priznaky u epilepsie temporalniho laloku. Elektrofyziologicko-klinicka analyza iktalni dystonie, iktalniho a postiktalniho priznaku treni nosu a iktalniho vomitu.

The correct evaluation of localizing and lateralizing ictal and postictal signs in patients with temporal lobe epilepsy has a significant value within the complex evaluation prior to epilepsy surgery. The most common lateralizing signs in seizures arising from the temporal lobe are ictal dystonia, ictal paresis, head and eye version, lateralized automatism, ictal speech, ictal and postictal aphasia, ictal and postictal nose wiping and ictal vomiting. All of these symptoms are very useful in seizure lateralization, although their value is not absolute. This study analyzes three of the above-mentioned signs in detail: ictal dystonia, ictal and postictal nose wiping and ictal vomiting. Our results confirm the significant lateralizing value of ictal dystonia (contralateral to the seizure onset). There was no evidence of paroxysmal epileptic activity in the contralateral basal ganglia (putamen) during ictal dystonia in our study. This result does not confirm the recently published observations that hypothesized that the spread of epileptic activity to the contralateral basal ganglia structures is a cause of this ictal symptom. In our study the paroxysmal ictal activity was spread over the large cortical areas within the temporal and frontal lobes contralaterally at the time of the onset of this sign. The results of our study confirm the high lateralizing value of both ictal and postictal nose wiping, using the upper limb ipsilateral to the seizure onset until three minutes after the seizure offset. This study presents a detailed analysis of three patients with ictal vomiting, and evaluates the relationship between ictal vomiting and the non-dominant hemisphere. We discuss the probable genesis of each of the above-mentioned symptoms. This study should be seen as the beginning of a careful analysis of other valuable ictal epileptic signs in patients.Available from STL Prague, CZ / NTK - National Technical LibrarySIGLECZCzech Republi