The Role of Seizure Evolution for the Localizaion of the Epileptogenic Zone

Epileptic seizures frequently evolve from one seizure type to another. There are typical seizure sequences, which point to different epilepsy syndromes. For example, generalized myoclonic seizures not infrequently occur in cluster, particularly if precipitated by sleep deprivation and evolve into a generalized tonic-clonic seizure. Another example is abdominal aura, which is followed by an automotor seizure. This sequence is frequently, although not exclusively, seen in patients with temporal epilepsy. The version of the eyes and the head during epileptic seizures was reported to have a lateralizing significance. However, this has been debated by other investigators. We could recently show that the sequence of the head movement during the seizure evolution is crucial for the lateralization of the seizure onset zone.

In summary, the analysis of seizure sequences provides valuable information about the epileptogenic zones and epilepsy syndromes.