PSYCHOMOTOR SEIZURES OF TEMPORAL-LOBE ONSET - ANALYSIS OF SYMPTOM CLUSTERS AND SEQUENCES

We analyzed 91 psychomotor seizures from 31 patients seizure free at l east one year after temporal lobectomy (implying temporal lobe onset). Fifty symptoms were looked for in every seizure and their time of ons et and ending noted. Statistical analysis was used to define symptom c lusters and the order of appearance of symptoms. Of the eighteen most common symptoms examined, all of these symptoms from a tight cluster s howing a high degree of correlation. Within this cluster, there was a tendency towards the following subclusters: (a) epigastric aura, ictal vomiting, alimentary and hand automatisms; (b) behavioral arrest, com plete loss of consciousness, staring and bilateral facial contraction; (c) milateral dystonic posturing of an arm, mimetic automatisms, comp lex gestures, ictal speech and partial loss of consciousness; (d) look ing around, agitation, vocalizations and whole body movements. We also found a strong correlation between epigastric sensation and ictal vom iting in psychomotor seizures arising from the right but not the left temporal lobe. The commonest sequence of symptoms was: behavioral arre st followed by alimentary and hand automatisms, looking around and who le body movements, in that order.