{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,11]],"date-time":"2025-05-11T04:03:16Z","timestamp":1746936196972,"version":"3.40.5"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Typical semiology with associated 5As (Antecedent, Aura, Arrest, Automatisms, and Amnesia) is the prototypical seizure manifestation of temporal lobe epilepsy (TLE) in adults. However, patients with TLE can present with seizure phenomenology referred to as \u201chypermotor TLE\u201d (HMS\u2010TLE) which can mimic extratemporal focal epilepsy. We studied the clinico\u2010electrographic, imaging profile, and surgical outcomes of drug\u2010resistant HMS\u2010TLE patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed the ictal signs and electroencephalography data of HMS\u2010TLE patients who became seizure free following epilepsy surgery with a minimum follow\u2010up of 1\u2009year and compared them with patients with typical TLE (1:2 ratio). Hypermotor seizures were identified based on the presence of stereotyped ictal complex movements at seizure onset including body rocking, pelvic thrusting, and bimanual and bipedal movements with\/without affective components.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 684 patients with drug\u2010resistant TLE who underwent surgery during 2010\u20132020, 16 patients (2.34%) met criteria for HMS\u2010TLE and were compared with 32 patients with typical TLE. Predominant \u201chypermotor\u201d components included motor agitation, bicycling\/kicking movements, body gyration followed by violent automatisms, and pelvic thrusting. Age at epilepsy onset, age at video telemetry recording, age at surgery, duration of epilepsy at surgery, gender distribution, and presence of aura were comparable between the two groups. History of febrile seizures (31.3% vs. 65.6%; <jats:italic>p<\/jats:italic>\u2010value = .024), presence of hippocampal sclerosis on MRI, and histopathology (56.3% vs. 90.6%; <jats:italic>p<\/jats:italic>\u2010value = .006 and 50% vs. 96.9%; <jats:italic>p<\/jats:italic>\u2010value = .002, respectively) were lower, and temporal neocortical abnormalities on MRI (87.5% vs. 59.4%, <jats:italic>p<\/jats:italic>\u2010value = .048), dysplasia on histopathological evaluation (25% vs. 0%, <jats:italic>p<\/jats:italic>\u2010value = .003) were higher in HMS\u2010TLE. HMS\u2010TLE group had lower number of patients with focal\u2010onset ictal patterns (37.5% vs. 90.6%, <jats:italic>p<\/jats:italic>\u2010value = .0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Hypermotor seizures are rare in TLE, however it does not preclude non\u2010invasive selection for surgery. Hence, physicians should be aware of this subtype of drug\u2010resistant TLE as early intervention can have good surgical outcomes, akin to typical TLE.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epd2.20327","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T07:21:01Z","timestamp":1739863261000},"page":"244-254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypermotor temporal lobe epilepsy revisited\u2010expanding the\u00a0spectrum"],"prefix":"10.1002","volume":"27","author":[{"given":"Pavan Kumar","family":"Rudrabhatla","sequence":"first","affiliation":[{"name":"Department of Neurology, R. Madhavan Nayar Center for Comprehensive Epilepsy Care Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayakumari","family":"Nandana","sequence":"additional","affiliation":[{"name":"Department of Neurology, R. Madhavan Nayar Center for Comprehensive Epilepsy Care Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George C.","family":"Vilanilam","sequence":"additional","affiliation":[{"name":"Department of Neurology, R. Madhavan Nayar Center for Comprehensive Epilepsy Care Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)  Trivandrum India"},{"name":"Department of Neurosurgery SCTIMST  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bejoy","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Neurology, R. Madhavan Nayar Center for Comprehensive Epilepsy Care Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)  Trivandrum India"},{"name":"Department of Imaging Sciences &amp; Interventional Radiology SCTIMST  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandrasekharan","family":"Kesavadas","sequence":"additional","affiliation":[{"name":"Department of Neurology, R. Madhavan Nayar Center for Comprehensive Epilepsy Care Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)  Trivandrum India"},{"name":"Department of Imaging Sciences &amp; Interventional Radiology SCTIMST  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8564-8436","authenticated-orcid":false,"given":"Ashalatha","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Department of Neurology, R. Madhavan Nayar Center for Comprehensive Epilepsy Care Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0972-3307","authenticated-orcid":false,"given":"Ramshekhar N.","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Neurology, R. Madhavan Nayar Center for Comprehensive Epilepsy Care Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_12_2_1","DOI":"10.1155\/2012\/751510"},{"doi-asserted-by":"publisher","key":"e_1_2_12_3_1","DOI":"10.1111\/j.1528-1157.1989.tb05467.x"},{"doi-asserted-by":"publisher","key":"e_1_2_12_4_1","DOI":"10.1016\/j.seizure.2013.07.009"},{"doi-asserted-by":"publisher","key":"e_1_2_12_5_1","DOI":"10.1212\/01.wnl.0000187069.64164.1b"},{"doi-asserted-by":"publisher","key":"e_1_2_12_6_1","DOI":"10.1212\/WNL.0000000000002666"},{"doi-asserted-by":"publisher","key":"e_1_2_12_7_1","DOI":"10.1111\/j.1528-1167.2006.00510.x"},{"doi-asserted-by":"publisher","key":"e_1_2_12_8_1","DOI":"10.1111\/j.1528-1167.2008.01675.x"},{"doi-asserted-by":"publisher","key":"e_1_2_12_9_1","DOI":"10.1111\/epi.12490"},{"doi-asserted-by":"publisher","key":"e_1_2_12_10_1","DOI":"10.1016\/j.yebeh.2013.05.030"},{"doi-asserted-by":"publisher","key":"e_1_2_12_11_1","DOI":"10.1016\/j.jocn.2019.06.026"},{"doi-asserted-by":"publisher","key":"e_1_2_12_12_1","DOI":"10.1111\/j.1528-1167.2011.03100.x"},{"doi-asserted-by":"publisher","key":"e_1_2_12_13_1","DOI":"10.1111\/j.1528-1167.2010.02590.x"},{"doi-asserted-by":"publisher","key":"e_1_2_12_14_1","DOI":"10.1111\/j.1528-1167.2007.01426.x"},{"doi-asserted-by":"publisher","key":"e_1_2_12_15_1","DOI":"10.1016\/j.yebeh.2012.04.095"},{"doi-asserted-by":"publisher","key":"e_1_2_12_16_1","DOI":"10.1111\/j.1528-1167.2009.02397.x"},{"key":"e_1_2_12_17_1","first-page":"764","volume-title":"Surgical treatment of the epilepsies","author":"Engel J","year":"1987"},{"doi-asserted-by":"publisher","key":"e_1_2_12_18_1","DOI":"10.1016\/S1388-2457(01)00591-0"},{"doi-asserted-by":"publisher","key":"e_1_2_12_19_1","DOI":"10.1002\/ana.26496"},{"doi-asserted-by":"publisher","key":"e_1_2_12_20_1","DOI":"10.1016\/j.yebeh.2015.11.017"},{"doi-asserted-by":"publisher","key":"e_1_2_12_21_1","DOI":"10.1111\/epi.14517"},{"doi-asserted-by":"publisher","key":"e_1_2_12_22_1","DOI":"10.1212\/01.WNL.0000106945.68292.DC"},{"doi-asserted-by":"publisher","key":"e_1_2_12_23_1","DOI":"10.1007\/s10072-005-0491-9"},{"doi-asserted-by":"publisher","key":"e_1_2_12_24_1","DOI":"10.1016\/j.eplepsyres.2008.07.005"},{"doi-asserted-by":"publisher","key":"e_1_2_12_25_1","DOI":"10.1016\/j.eplepsyres.2009.06.007"},{"doi-asserted-by":"publisher","key":"e_1_2_12_26_1","DOI":"10.1111\/j.1528-1167.2010.02537.x"},{"doi-asserted-by":"publisher","key":"e_1_2_12_27_1","DOI":"10.1016\/S0306-4522(02)00446-3"},{"doi-asserted-by":"publisher","key":"e_1_2_12_28_1","DOI":"10.1002\/cne.20796"},{"doi-asserted-by":"publisher","key":"e_1_2_12_29_1","DOI":"10.1016\/j.neuroimage.2007.09.012"},{"doi-asserted-by":"publisher","key":"e_1_2_12_30_1","DOI":"10.1093\/acprof:oso\/9780195104233.001.0001"},{"doi-asserted-by":"publisher","key":"e_1_2_12_31_1","DOI":"10.3389\/fneur.2018.00243"},{"doi-asserted-by":"publisher","key":"e_1_2_12_32_1","DOI":"10.1111\/epi.14690"}],"container-title":["Epileptic Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epd2.20327","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T10:53:10Z","timestamp":1746874390000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epd2.20327"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,17]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/epd2.20327"],"URL":"https:\/\/doi.org\/10.1002\/epd2.20327","archive":["Portico"],"relation":{},"ISSN":["1294-9361","1950-6945"],"issn-type":[{"type":"print","value":"1294-9361"},{"type":"electronic","value":"1950-6945"}],"subject":[],"published":{"date-parts":[[2025,2,17]]},"assertion":[{"value":"2024-05-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}