Abstract
We reviewed auras in 50 temporal lobe epilepsy patients with discrete lesions who underwent resection surgery for intractable temporal lobe epilepsy. The size of all lesions was less than 4 cm on CT/MRI. All patients were postoperatively followed for over 2 years, and their seizure outcome was class-I or II according to Engel's criteria. Based on the location of lesions, the patients were classified into three groups; mesial, polar, and lateral. Aura types were compared between the lateral group and the polarmesial group, and its occurrence was compared in patients with lesions at the speech dominant and nondominant sides. Dysmnestic and dysphasic auras were more frequent in the lateral group. The incidence of other psycic auras (cognitive, affective) was not different between the lateral and the polar-mesial groups. Patients with lesions at the speech dominant side tended to have no aura. Dysmnestic and affective auras were more common in the patients with lesions at the nondominant side. These results demonstrate that the location and lateralization of lesions make for a difference in the nature and occurrence of special subtypes of psychic auras.
