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Unidirectional whole body turning: a new lateralising sign in complex partial seizures.

Shukla G, Bhatia M, Padma Srivastava MV, Tripathi M, Srivastava A, Singh VP, Saratchandra P, Gupta A, Gaikwad S, Bal CS, Jain S

Department of Neurology, All India Institute of Medical Sciences, New Delhi -- 110029, India. garimas@aiims.ac.in

BACKGROUND: The lateralising significance of unidirectional whole body turning in patients with complex partial seizures (CPS) arising from the temporal lobe was evaluated. METHODS: A total of 330 patients undergoing long term video-EEG study were included. "Unidirectional whole body turning" was defined as rotation of the trunk, head, and limbs by >90 degrees and lasting >10 s. EEG correlates, MRI, and SPECT findings were compared and outcome after surgery was noted for patients with follow up data for >1 year. RESULTS: Unidirectional whole body turning was observed in 13 patients with a mean age of 18+/-8 years. Concordance of the side of whole body turning with the EEG focus and MRI findings was observed in 11 of the 13 patients (84.7%) and in 26 of 28 seizures (92.8%). The six patients who underwent temporal lobectomy or resection of lesion, opposite to the direction of body turning, had good seizure outcome. CONCLUSION: Unidirectional whole body turning is a new lateralising sign in temporal lobe CPS with good predictive value for epileptogenic focus contralateral to the direction of turning.

Published 18 November 2005 in J Neurol Neurosurg Psychiatry, 76(12): 1726-9.
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