Hand Postures and Localization Value in Patients at Video EEG Monitorization

One third of pediatric patients with epilepsy are drug-resistant. Epilepsy surgery can be applied to appropriate patients when antiepileptic therapy is insufficient in resistant epilepsy. Long-term video EEG monitoring is performed to evaluate suitability for epilepsy surgery. The hand postures of patients with intractable epilepsy who underwent in our video EEG monitoring (VEM) unit during ictal activity and the relationship of these postures with the epileptogenic zone were evaluated. The ictal activities of patients hospitalized in the video EEG monitoring unit between 2013-2021 were examined. Hand postures of patients during ictal activity were classified into six subgroups. These hand postures are defined as fist, politician fist, cup, pincer, extended hand and pointing. Epileptogenic foci of the patients were classified as generalized and focal. Five hundred and twenty-three patients who were monitored in VEM unit were screened, and fifty-five patients were evaluated. The most common epileptic hand postures were “fist” and “politician fist”. Extended hand, cup, pointing and pincer postures were seen with decreasing frequency. The epileptogenic zone of 18 patients out of 55 was found to be generalized. It was observed that 14 patients originated from the temporal, 12 patients from the frontocentral, 8 patients from the frontotemporal, 3 patients from the temporoparietal. Fist, politician's fist and extended hand posture were evaluated as contralateral lateralized sign, and pincer, pointing hand and cup postures were evaluated as ipsilateral lateralized signs. Hand postures can be used as lateralizing and localizing findings.
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