Unidirectional whole body turning: a new lateralising sign in complex partial seizures

Background: The lateralising significance of unidirectional whole body turning in patients with complex partial seizures (CPS) arising from the temporal lobe was evaluated. Methods: A total of 330 patients undergoing long term video-EEG study were included. “Unidirectional whole body turning” was defined as rotation of the trunk, head, and limbs by >90° and lasting >10 s. EEG correlates, MRI, and SPECT findings were compared and outcome after surgery was noted for patients with follow up data for >1 year. Results: Unidirectional whole body turning was observed in 13 patients with a mean age of 18±8 years. Concordance of the side of whole body turning with the EEG focus and MRI findings was observed in 11 of the 13 patients (84.7%) and in 26 of 28 seizures (92.8%). The six patients who underwent temporal lobectomy or resection of lesion, opposite to the direction of body turning, had good seizure outcome. Conclusion: Unidirectional whole body turning is a new lateralising sign in temporal lobe CPS with good predictive value for epileptogenic focus contralateral to the direction of turning.