{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T04:23:18Z","timestamp":1792815798064,"version":"4.5.0"},"reference-count":61,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To elucidate the lateralizing value of ictal head turning in focal epilepsy and provide guidance for interpreting ictal semiology within the framework of presurgical evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a systematic review of ictal head turning. We included studies reporting ictal head turning (versive, nonversive, and gyration) captured in video\u2010EEG recordings during presurgical evaluation. We assessed potential selection and assessment bias and evaluated confidence in the epileptogenic zone based on reported comparators\u2014including resection site and surgical outcomes, intracerebral EEG, and MRI findings. Studies were classified as high quality if potential bias was low and confidence in the epileptogenic zone was high.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Versive head turning is usually contralateral to the epileptogenic zone (high level of evidence). Nonversive head turning is most often ipsilateral to the epileptogenic zone in temporal lobe epilepsy (high level of evidence) and contralateral in occipital lobe epilepsy (moderate level of evidence). In frontal lobe epilepsy, the lateralization of nonversive head turning may vary based on sub\u2010lobar localization, but high\u2010level evidence is lacking. Gyratory seizures are likely contralateral when initiated by versive head turning and evolving into focal\u2010to\u2010bilateral tonic\u2013clonic seizures; in other cases, they may be ipsilateral, particularly in temporal and mesial frontal epilepsy, but the available evidence is insufficient for a definitive conclusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>The lateralizing value of ictal head turning depends on its specific characteristics and clinical context.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epd2.70046","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T09:49:48Z","timestamp":1747993788000},"page":"568-578","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lateralizing value of ictal head turning: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"27","author":[{"given":"Melita","family":"Cacic Hribljan","sequence":"first","affiliation":[{"name":"Department of Clinical Neurophysiology Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Pediatrics Children's Hospital Srebrnjak  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8282-1034","authenticated-orcid":false,"given":"Georg","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurological Intensive Care and Neurorehabilitation Christian Doppler University Hospital, Paracelsus Medical University and Center for Cognitive Neuroscience, Member of the European Reference Network EpiCARE  Salzburg Austria"},{"name":"Research Programme Biomedical Data Science Paracelsus Medical University  Salzburg Austria"},{"name":"Department of Artificial Intelligence and Human Interfaces Paris Lodron University  Salzburg 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