{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T04:23:15Z","timestamp":1792815795201,"version":"4.5.0"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      We performed a systematic review of the ictal semiology of the\n                      <jats:italic>lateral temporal lobe<\/jats:italic>\n                      in focal epilepsy aiming to summarize the state\u2010of\u2010the\u2010art anatomo\u2010clinical correlations in the field and help guide interpretation of ictal semiology within the framework of pre\u2010surgical evaluation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>After preregistration of the study protocol (PROSPERO\u2010ID CRD42024498889), we used the PRISMA\u2010based approach and systematically searched PubMed and EMBASE for relevant literature on the semiology of lateral temporal lobe epilepsy (TLE). A random\u2010effects meta\u2010analysis with the inverse variance method was used to calculate pooled estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six studies with 94 patients fulfilled our inclusion criteria. All studies also included patients with TLE confined to other neocortical temporal structures without performing analyses specifically on lateral temporal structures. The most common signs comprised oral automatisms, manual automatisms, and behavioral arrests; however, these likely do not manifest at seizure onset but during propagation. Overall, GRADE evaluation indicated very low evidence for any signs or symptoms being associated with anatomic localization. We performed a meta\u2010analysis of the diagnostic accuracy of the presence or absence of relevant ictal signs and symptoms for differentiating seizures in lateral versus mesial TLE. The presence of auditory auras was highly specific for lateral TLE (.98 [95% CI .88\u20131.00]) with an overall sensitivity of .06 [95% CI .02\u2013.22]. Lack of epigastric or olfactory\/gustatory aura was associated with a high sensitivity for differentiating lateral from mesial TLE (.93 [95% CI .80\u2013.98] and .96 [95% CI .84\u2013.99], respectively); specificity was .38 [95% CI .26\u2013.51] for lack of epigastric aura and .13 [95% CI .06\u2013.25] for lack of olfactory\/gustatory aura.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>The six studies included in this systematic review defined the boundaries of the lateral temporal lobe quite heterogeneously and only about two\u2010thirds of patients unambiguously had lateral temporal lobe epilepsy likely explaining the wide spectrum of ictal semiologies. Furthermore, there is often no differentiation into seizure onset versus propagation. Auditory auras represent the only specific semiology for lateral TLE, though this symptom occurs in less than every 10th patient. Comparing lateral versus mesial temporal lobe epilepsy, the presence of epigastric auras and even more so of olfactory\/gustatory auras indicates mesial rather than lateral seizure onset.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epd2.70189","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T12:26:02Z","timestamp":1770035162000},"page":"678-689","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ictal semiology in lateral temporal epilepsy: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8682-0215","authenticated-orcid":false,"given":"Jakob I.","family":"Doerrfuss","sequence":"first","affiliation":[{"name":"Department of Neurology with Experimental Neurology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin  Berlin Germany"}],"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, Center for Cognitive Neuroscience, Member of the European Reference Network EpiCARE Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2258-1670","authenticated-orcid":false,"given":"Martin","family":"Holtkamp","sequence":"additional","affiliation":[{"name":"Department of Neurology with Experimental Neurology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin  Berlin Germany"},{"name":"Epilepsy\u2010Center 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