The localizing and lateralizing value of palpitation aura in patients with focal epilepsy

Abstract The semiology of auras is essential to presurgical evaluation of patients with focal epilepsy. To assess the localizing and lateralizing value of palpitation aura in focal epilepsy, we retrospectively analyzed the demography, electroclinical, neuroimaging, surgical, pathology data, and outcomes of 114 patients with focal epilepsy and the palpitation aura occurrence in relation to epileptogenic (temporal vs extratemporal, left vs right) origin. Out of 114 patients (mean age, 23.44 ± 9.69 years), 17 (14.9%) patients experienced palpitation as the first aura. Twelve had temporal, one had parietal, one had occipital lobe, and three had multiple lobes junction onset seizures. Palpitation aura was observed more frequently in temporal epilepsy: 22.2% of temporal lobe epilepsy (TLE) and 8.3% of extratemporal lobe epilepsy (EX-TLE) exhibited palpitation aura ( p  = 0.038). However, palpitation aura had no difference between the left or right side: 16.4% with right-sided epilepsy and 13.2% with left-sided epilepsy exhibited palpitation aura ( p  = 0.634). Thus, our study suggested that palpitation was a frequent aura in patients with focal epilepsy. It is more commonly seen with temporal lobe origin, but it has no lateralizing value.