We analyzed the spectrum of ictal emotional behaviors, reviewing video -EEG recordings of 477 seizures of 81 candidates to epilepsy surgery (45 temporal/36 frontal lobe), 51 studied with SEEG. The clinical interpretation of emotion - including facial expression of emotion (FEE), motor and/or verbal behavior and coherent emotional experience - has been validated by psychological studies (F.A.C.S., spectrograms, body movements rating). We compared prevalence and features of the six basic emotions (Anger, Fear, Happiness, Disgust, Sadness and Surprise). In 60% of seizures we observed emotional manifestations, ranging from isolated FEE to complex motor/acoustic behaviors (21% of seizures); only in 13% of seizures the experience of emotion was referred. FEEs had similar prevalence in frontal (52%) and temporal (66%) lobe seizures and in both genders, but female more frequently shoved also an emotional behavior and/or referred an emotional feeling. All the six basic emotions were represented; about 25% of FEE were blended. Anger, Fear, disgust, sadness were related with right ictal discharge. Fear and disgust were associated with oro-alimentary automatisms. The same patient expressed 1. 3 types of ictal emotions (mean 1.6) and up to three different emotion could emerge in one single seizure (mean 1.3). Only 35% of patients presented the same type of emotion in all seizure, with variable latency. In conclusion, ictal emotional manifestations consist in a spectrum of events, that show inter and infra-individual heterogeneity. The association of ictal emotions and complex automatisms supports the hypothesis of the involvement of a wide physiological network including prefrontal, fronto-mesial and temporal limbic structures; the right prevalence of the ictal discharge confirms the hemispheric right specialization for emotions. The sexual dimorphism in expressing ictal emotions suggests the involvement of "universal" cross-cultural mechanisms.
|Translated title of the contribution||Ictal emotional behaviors|
|Number of pages||3|
|Journal||Bollettino - Lega Italiana contro l'Epilessia|
|Publication status||Published - Jul 2006|
ASJC Scopus subject areas
- Clinical Neurology