Clinical features and ictal patterns in epileptic patients with EEG temporal lobe foci

The clinical features and subjective ictal phenomena in 270 epileptic patients with electrographic temporal lobe foci are reported. The ictal manifestations observed in 199 of these patients are described and compared with those in epileptic patients with extratemporal foci reported previously. Sixty‐four percent of the patients reported historical data of possible etiological importance, but one could be reasonably certain of the cause in only 27%. Eighty‐three percent of the patients reported auras, 80% exhibited localized motor activity, and 95% demonstrated automatic behavior. Compared to patients with extratemporal foci, the patients reported here had a higher incidence of visceral (41%), complex (52%), and olfactory‐gustatory (13%) auras and of automatic behavior. On the other hand, no ictal phenomenon was unique to patients with temporal localization. The data do not support the concept of an association between “temporal lobe epilepsy” and violence.