Analysis of semiology of mesial temporal lobe epilepsy with hippocampal sclerosis

Objective To study the semiological characteristics of mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis(HS).Methods The semiology of 14 patients with MTLS,who had seizures-free at least for one year after selective hippocampus-amygadala resection from January 2011 to June 2012 were retrospectively analyzed.Results Fifty-seven epileptic seizures were recorded in 14 patients.11 seizures occurred in sleep,while 46 in awake.10 patients had auras seizures.All patients had automatism seizure.13 patients had autonomic seizures with tachycardia.6 patients'head and eyes deviated to the ipsilateral side.2 patients'head and eyes deviated to the contralateral side.12 patients had contralateral upper limb tonic.4 patients had contralateral version.5 patients had secondary generalized tonic-clonic seizures.3 patients used ipsilateral hand touching nasal or facial postictal.Conclusions The main seizures of MTLE with HS manifested:aura seizure→automatism seizure→autonomic seizure(tachycardia) →contralateral limb tonic seizures,rarely secondarily GTCS.The unilateral upper limbic automotor during the ictal period was located ipsilateral to epileptogenic side.The unilateral limb tonic and head version was often located contralateral to the epileptogenic side.Head and eyes' deviation were mainly seen at the same side of the epileptogenic focus.Aura seizures had no lateralized value. Key words: Epilepsy, temporal lobe;  Hippocampal sclerosis;  Aura seizures;  Automotor seizures