Review Article
Temporal Lobe Epilepsy Semiology
Table 2
Semiological Features (TLE) - Lateralizing or Localizing Value.
| Feature | Location |
| Automatism | |
| Unilateral limb automatism | Ipsilateral focus | Oral automatism | (m)Temporal lobe | Unilateral eye blinks | Ipsilateral to focus | Postictal cough | Temporal lobe | Postictal nose wiping | Ipsilateral temporal lobe | Ictal spitting or drinking | Temporal lobe focus (R) | Gelastic seizures | (m)Temporal, hypothalamic, frontal (cingulate) | Dacrystic seizures | (m)Temporal, hypothalamic | Unilateral limb automatisms | Ipsilateral focus | Whistling | Temporal lobe |
| Autonomic | |
| Ictal emeticus | Temporal lobe focus (R) | Ictal urinary urge | Temporal lobe focus (R) | Piloerection | Temporal lobe focus (L) |
| Motor | |
| Early nonforced head turn | Ipsilateral focus | Late version | Contralateral focus | Eye deviation | Contralateral focus | Focal clonic jerking | Contralateral perirolandic focus | Asymmetrical clonic ending | Ipsilateral focus | Fencing (M2E) | Contralateral (supplementary motor) | Figure 4 | Contralateral to the extended limb (temporal) | Tonic limb posturing | Contralateral focus | Dystonic limb posturing | Contralateral focus | Unilateral ictal paresis | Contralateral focus | Postictal Todd’s paresis | Contralateral focus |
| Speech | |
| Ictal speech arrest | Temporal lobe (usually dominant hemisphere) | Ictal speech preservation | Temporal lobe (usually nondominant) | Postictal aphasia | Temporal lobe (dominant hemisphere) |
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