We reviewed 127 seizures in 19 consecutive patients with temporal lobe
epilepsy (TLE) documented by EEG/closed-circuit TV (EEG-CCTV) monitor
ing. Ten patients had seizure onset in the right temporal lobe (RTL, 5
4 seizures), and 9 had seizure onset in the left temporal lobe (LTL, 7
3 seizures). We compared the clinical characteristics in the two group
s and analyzed the seizures for frequency of auras, seizures secondari
ly generalized, automatisms, tonic head deviation, focal posturing and
jerking, ictal speech, and postical manifestations. Automatisms overa
ll were more common in the RTL group, but individual categories (extre
mity, head and trunk, oroalimentary) were comparable among the two gro
ups. Contralateral focal jerking and tonic head deviation were more co
mmon in LTL lobe seizures, as were secondarily generalized seizures. I
n addition to focal motor symptoms, three features were most statistic
ally significant in distinguishing the two groups: Postictal aphasia o
ccurred exclusively in the LTL group, whereas well-formed ictal speech
and rapid return to baseline postictally were noted only in RTL seizu
res.