Localizing and lateralizing value of epileptic symptoms in temporal lobe epilepsy

The symptoms and signs associated with all stages of a temporal lobe seizur e may be helpful in determining both the localization and lateralization of seizure onset. Auras, when present, may be very suggestive of temporal lob e onset and may further localize to a mesiobasal or lateral temporal lobe s ite of onset. During the ictus, automatisms and motor phenomena may be high ly indicative of temporal lobe seizure activity and may even help lateraliz e the discharge. In the post-ictal period, motor paresis and aphasia are he lpful in lateralization. Video E.E.G. data has provided extensive informati on on the utility of ictal symptomatology in seizure localization. Thus, th e seizure semiology provides important adjunctive information in evaluating patients for epilepsy surgery and should be concordant with information ob tained from ictal EEG, neuroimaging and neuropsychology.