Preserved Responsiveness during Complex Partial Seizures ofMesial Temporal Lobe Epilepsy

J Korean Neurol Assoc > Volume 18(6); 2000 > Article

Journal of the Korean Neurological Association 2000;18(6): 706-710.

내측 측두엽간질의 복합부분발작에서 반응보존성

손영민, 김한영 ·서대원 ·홍승봉

성균관대학교 의과대학 삼성서울병원 신경과학교실

Preserved Responsiveness during Complex Partial Seizures ofMesial Temporal Lobe Epilepsy

Young-Min Shon, M.D., Hahn Young Kim, M.D., Dae Won Seo, M.D., Seung Bong Hong, M.D.

Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine

Abstract

Background : Preserved responsiveness (PR) can be observed in complex partial seizures (CPS) of temporal lobe epilepsy (TLE). In order to investigate the seizure lateralization value of PR and the degree of PR to different types of commands, we analyzed the CPS of the patients with mesial TLE. Methods : The interviews consisted of four cate-gories including verbal (word memory, orientation, verbal command) and nonverbal (motor command) questions. We defined PR as showing more than one correct response during the ictal period. The language dominance was determined in all patients by the Wada test. Results : Out of 132 patients, eight showed PR during seizures. Two patients had 6 seizures arising from the dominant hemisphere (DHS) and six patients had 15 seizures arising from the nondominant hemisphere (NDHS). The number of total questions in the DHS was 65 (word memory; 6, orientation; 18, motor com-mand; 23, verbal command; 18) and in the NDHS was 104 (15, 27, 28, 34 each). The number of PR was 15 (23.1%) in the DHS whereas 70 (67.3%) in the NDHS, indicating that PR was more frequently seen in the NDHS (p<0.001). The DHS showed no PR to word memory, orientation and only one to verbal command during seizures, but the NDHS had 6 PR for word memory, 20 for orientation and another 20 for verbal command. The number of PR to motor command was 14 (60.9%) in the DHS and 24 (85.7%) in the NDHS (p<0.05). Conclusions : The PR to word memory, orientation, and verbal command strongly suggests the NDHS. The PR to motor command was observed more frequently in the NDHS than in the DHS.J Korean Neurol Assoc 18(6):706~710, 2000Key Words : Preserved responsiveness, Temporal lobe epilepsy, Language dominance