Ictal motor sequences: Lateralization and localization values

摘要: SummaryObjective To determine the lateralization and localization values of ictal motor sequences in setting focal epilepsy ending with a secondarily generalized seizure. Methods Retrospectively, were analyzed patients seizure by three readers blinded to all clinical electrographic data. One representative per patient was selected. Prevalence, positive predictive value (PPV), Fleiss Kappa for following signs calculated: version, unilateral limb tonic posturing, clonic seizure, figure-of-4, M2e, hand dystonia, asymmetric ending, Todd's paralysis. Sequences PPV ≥ 80% then their values. Results A total 47 seizures studied. The “reliable” robust lateralizing (PPV > 80%) Figure-of-4 dystonia had relatively low PPV, therefore not included sequence analysis, which only 38 two or more high PPV. Multiple combinations temporal progression seen these patients, version being most common initial sign (29 patients) usually followed M2e (15 29 patients), and/or (7 patients). Accurate epileptogenic zone (EZ) PPV 100% can be predicted when reliable point same side. However, various did differentiate between extratemporal epilepsy. Significance The presence is extremely valuable EZ, but determining EZ. This especially useful surgery indicated.