Semiology of seizures with temporo-polar or “medio-lateral” temporal origin: A systematic review

A systematic review using PRISMA criteria was used to review the literature regarding the specific semiology of seizure arising (a) from the temporal pole or (b) from both medial and lateral temporal cortex. Evidence was analyzed with regard to information provided by intracranial EEG recordings and surgical outcomes, and an estimation of validity of reported signs and symptoms was performed. Semiology of seizures originating from the temporal pole was mostly related to diverse patterns of ictal spread rather than to the localization of seizure origin and comprised a wide variety of early signs and symptoms. Seizures with rapid involvement of temporo-medial and temporo-lateral cortex were intermediate in semiology between medial and lateral onset seizures and may have more frequently early automatisms and early vocalization than seizures arising from temporo-medial or temporo-lateral cortex only. Results of this review are discussed as to limiting factors of origin-based analyses for the understanding of seizure semiology.