Objective: To explore the lateralizing value of dystonic posturing (DP) of upper limb in patients with refractory mesial temporal lobe epilepsy (MTLE).
Methods: Presurgical videotypes of 89 patients staying seizure-free for at least 2 years after temporal lobectomy were retrospectively reviewed. Attention was paid to temporal correlation between occurrence of DP and seizure and the relationship of DP to side of epileptogenic zone (resected side).
Results: DP was observed in 92 complex partial seizure (CPS) from 37 (41.6%) patients among 89 patients with a total of 424 CPS. DP was not an initial symptom in the course of CPS and its onset occurred mostly in the middle third of ictus. DP displayed a high positive predictive value of 93.9% for lateralizing a contralateral seizure onset.
Conclusion: DP is a reliable lateralizing sign in patients with MTLE.