Simple Gesture -- Nose Wiping -- Identifies Origin Of Epileptic Seizure

Researchers studied 101 patients with difficult-to-treat seizures that are confined to one area of the brain. Patients were admitted to an epilepsy monitoring unit for a presurgical evaluation. While reviewing 440 video-taped seizures of the patients, researchers noticed many individuals frequently wiping their noses after a seizure.

"This simple gesture, nose wiping, accurately identified which side of the brain and location within the brain seizures originated in 97 percent of patients who wiped their noses," said neurologist and study author Christoph Baumgartner, MD, of the University Clinic of Vienna in Vienna, Austria. "Surprisingly, the hand a person uses to wipe his or her nose correlates with the same side of the body a seizure originates."

Nose wiping is a patient's reaction to an increased amount of fluids within the nasal airway. This often develops during or after seizures originating in the brain's temporal lobe. Coughing and producing extra saliva are also common after this type of seizure.

In preparing patients for surgery, physicians must identify the area where seizures originate. Nose wiping, along with other presurgical tests, offers physicians additional information about the origin of a seizure. Currently, brain imaging and neurophysiological tests are used to determine the location seizures originate.

Nose wiping was observed in 39 out of 76 patients with temporal lobe epilepsy and three out of 25 patients with extra-temporal lobe epilepsy. Post-seizure nose wiping occurred more often in patients with temporal lobe epilepsy originating on the right side compared to those with seizures originating on the left side.

Temporal lobe epilepsy is characterized by seizures causing a disturbance of brain activity originating in the temporal lobe of the brain; extra-temporal lobe seizures occur outside of the brain's temporal lobe. Temporal lobe seizures are the most common type of seizure confined to a specific area. Temporal lobe epilepsy can cause a variety of symptoms. A patient can experience a sudden loss of responsiveness while appearing to stare motionlessly, sudden and unprovoked sense of fear, strong sense of an unpleasant odor, deja vu, moaning or lip smacking movements.

Epilepsy affects about 2.5 million Americans. Epilepsy is a family of more than 40 neurological conditions that share a common symptom -- seizures.

The American Academy of Neurology, an association of more than 15,000 neurologists and neuroscience professions, is dedicated to improving patient care through education and research. For more information about the American Academy of Neurology visit the Web site at http://www.aan.com.