Table 2.
Semiological Features (TLE) - Lateralizing or Localizing Value.
| Feature | Location |
|---|---|
| Automatism | |
|
| |
| Unilateral limb automatism | Ipsilateral focus |
| Oral automatism | (m)Temporal lobe |
| Unilateral eye blinks | Ipsilateral to focus |
| Postictal cough | Temporal lobe |
| Postictal nose wiping | Ipsilateral temporal lobe |
| Ictal spitting or drinking | Temporal lobe focus (R) |
| Gelastic seizures | (m)Temporal, hypothalamic, frontal (cingulate) |
| Dacrystic seizures | (m)Temporal, hypothalamic |
| Unilateral limb automatisms | Ipsilateral focus |
| Whistling | Temporal lobe |
|
| |
| Autonomic | |
|
| |
| Ictal emeticus | Temporal lobe focus (R) |
| Ictal urinary urge | Temporal lobe focus (R) |
| Piloerection | Temporal lobe focus (L) |
|
| |
| Motor | |
|
| |
| Early nonforced head turn | Ipsilateral focus |
| Late version | Contralateral focus |
| Eye deviation | Contralateral focus |
| Focal clonic jerking | Contralateral perirolandic focus |
| Asymmetrical clonic ending | Ipsilateral focus |
| Fencing (M2E) | Contralateral (supplementary motor) |
| Figure 4 | Contralateral to the extended limb (temporal) |
| Tonic limb posturing | Contralateral focus |
| Dystonic limb posturing | Contralateral focus |
| Unilateral ictal paresis | Contralateral focus |
| Postictal Todd's paresis | Contralateral focus |
|
| |
| Speech | |
|
| |
| Ictal speech arrest | Temporal lobe (usually dominant hemisphere) |
| Ictal speech preservation | Temporal lobe (usually nondominant) |
| Postictal aphasia | Temporal lobe (dominant hemisphere) |