From the Research
Yes, automatisms are an indication for an electroencephalogram (EEG). Automatisms are repetitive, involuntary movements that often occur during seizures, particularly complex partial seizures originating from the temporal lobe. When a patient presents with automatisms, an EEG should be performed to detect abnormal electrical activity in the brain that may confirm the presence of seizures.
Key Points to Consider
- The EEG can help identify the seizure focus, characterize the type of seizure, and guide appropriate treatment with antiepileptic medications such as levetiracetam, carbamazepine, or lamotrigine.
- For optimal diagnostic yield, both routine and sleep-deprived EEGs may be necessary, and in some cases, long-term video-EEG monitoring for 24-72 hours might be required to capture events.
- Automatisms often indicate focal seizures with impaired awareness, and prompt EEG evaluation is essential for accurate diagnosis and effective management of the underlying seizure disorder, as supported by a recent study 1.
Clinical Features and Correlation with Seizure Onset Zones
- A cluster analysis of 74 surgically-treated cases identified semiologic features of automatisms correlating to different seizure onset zones (SOZ) 1.
- The distinct semiologic patterns of automatisms may provide information that may allow clinicians to define the SOZs, improving diagnostic accuracy and surgical outcome.
Lateralizing Signs in Temporal Lobe Epilepsy
- Nonmanipulative proximal upper extremity automatisms lateralize contralaterally in temporal lobe epilepsy, as described in a study published in Epilepsia 2.
- These automatisms are considered a reliable lateralizing sign to the contralateral hemisphere in TLE.