Complex Partial Seizures of Hippocampal and Amygdalar Origin

Summary: We studied the first clinical manifestations of 72 complex partial seizures (CPS) in 17 drug‐resistant patients. CPS were indicated to be of hippocampalamygdalar origin by scalp and depth EEG. We asked: (a) Do all CPS of hippocampal‐amygdalar origin start with an initial motionless stare and/or oroalimentary automatisms? (b) If not, what other clinical manifestations appear at onset of the CPS? Results showed that ˜39% of CPS begin with motionless staring, 25% with nonfocal discrete movements, 21% with oroalimentary automatisms, 10% with perseverative stereotyped automatisms, and 6% with vocalizations. Nonfocal discrete movements and oroalimentary automatisms were identified as the most common second and third clinical sequential manifestations during a CPS. We conclude that although ˜60% of CPS of hippocampal‐amygdalar origin start with motionless staring or oroalimentary automatisms, 40% do not.