{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:13:45Z","timestamp":1785248025778,"version":"3.55.0"},"reference-count":61,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Seizures originating from the anterior cingulate cortex (ACC) have distinct clinical features but can be difficult to identify in frontal lobe epilepsy (FLE). This systematic review examines the key semiology of ACC seizures and their anatomical correlations. A systematic search was conducted following PRISMA guidelines, including studies reporting ictal semiology, invasive EEG findings, and surgical outcomes in patients with ACC seizures, allowing for the establishment of anatomical and clinical correlations with a high level of confidence. Studies based only on stimulations were excluded. We selected 23 studies including 93 patients (57% males, 46% children). MRI positive (59%), invasive monitoring (74%), surgery (100%) with Engel class I outcome (80%) were the main characteristics. Cortical lesions were found by histology in 86% of the surgical specimen, including focal cortical dysplasia in 67%. The level of confidence in epileptogenic zone (EZ) localization was considered high and very high in 87% of patients. Auras reported by 58% of them mostly included affective (fear or negative emotional feelings) and\/or autonomic symptoms (80%). The main ictal signs consisted of facial emotional expressions (46%), autonomic features (48%), vocalization and sudden complex\/hypermotor behavior (60%). Spectacular manifestations with preserved awareness, verbalizations with emotional content, laughter, ictal pouting (\u201cchapeau de gendarme\u201d) can also point to ACC involvement. In contrast, dystonic\/tonic\u2013clonic features, head and eye deviations were less frequently observed (&lt;20%). Loss of consciousness was reported in 35% of patients. Immediate recovery at the seizure\u2010end was usual. Short seizures (&lt;1\u2009min) occurring in clusters during sleep were also characteristics. Combination of these features enhanced the likelihood of ACC origin. Interictal personality disorders which improved after seizure control can be also observed. ACC seizures are predominantly characterized by emotional, autonomic, and striking behavior manifestations contrasting with preserved awareness. These semiology markers support an anatomical and clinical entity and help to localize the EZ in FLE.<\/jats:p>","DOI":"10.1002\/epd2.70066","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T13:58:44Z","timestamp":1753451924000},"page":"883-900","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Ictal semiology in anterior cingulate epilepsy: A systematic review"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1970-6578","authenticated-orcid":false,"given":"Francine","family":"Chassoux","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Epilepsy Unit Lariboisi\u00e8re Hospital  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eve","family":"Sall\u00e8les","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Epilepsy Unit Lariboisi\u00e8re Hospital  Paris France"},{"name":"Paris Cit\u00e9 University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohan","family":"Caudron","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Epilepsy Unit Lariboisi\u00e8re Hospital  Paris France"},{"name":"Paris Cit\u00e9 University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrien","family":"Zanin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Epilepsy Unit Lariboisi\u00e8re Hospital  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agathe","family":"Laurent","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Epilepsy Unit Lariboisi\u00e8re Hospital  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7538-1931","authenticated-orcid":false,"given":"Dorottya","family":"Cserpan","sequence":"additional","affiliation":[{"name":"Department of Neuropediatrics University Children's Hospital, and University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7931-2327","authenticated-orcid":false,"given":"Georgia","family":"Ramantani","sequence":"additional","affiliation":[{"name":"Department of Neuropediatrics University Children's Hospital, and University of Zurich  Zurich Switzerland"},{"name":"Children's Research Center University Children's Hospital Zurich, and University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-195407000-00024"},{"key":"e_1_2_10_3_1","first-page":"3","article-title":"Clinical semiology of frontal lobe seizures","volume":"57","author":"Bancaud J","year":"1992","journal-title":"Adv Neurol"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0013-4694(73)90149-1"},{"key":"e_1_2_10_5_1","first-page":"705","article-title":"Behavioral manifestations induced by electric stimulation of the anterior cingulate gyrus in man","volume":"132","author":"Bancaud J","year":"1976","journal-title":"Rev Neurol (Paris)"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/118.1.279"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-64196-0.00019-4"},{"key":"e_1_2_10_8_1","first-page":"115","article-title":"The clinical signs and symptoms of frontal lobe seizures. 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