ABSTRACT
In this phase progressed to clonic movements of the right side of the face. The patient was aphasic in the postictal period and wiped her nose with her left hand. In the ILAE classification system, the patient would be regarded as having complex partial seizures, as there appeared to be an ‘alteration of consciousness’ during the seizure. However under the semiological classification system1 followed in the Cleveland Clinic, the patient would be classified as having automotor seizures progressing to right face clonic seizures, with lateralizing signs of postictal aphasia and postictal nose-wipe. The latter two features, and the right face clonic activity, suggested a dominant (left) hemisphere seizure onset.2,3
EEG seizures Regional left temporal. Seizures began with brief electrodecrement over the left temporal region. This was followed (usually within approximately 10 seconds) by rhythmic theta activity over the left temporal region, maximal over the left sphenoidal (Sp1) electrode. Theta activity usually lasted between 30-40 seconds followed by postictal slowing, again maximal over the left temporal region (Figure 152.2).
