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January 19, 2016: Ictal Spitting

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January 19, 2016

Ictal spitting

Spitting behavior has been infrequently reported in epileptic seizures. Only 20 patients with ictal spitting have been described.1 Fourteen of these cases were associated with seizure onset in the right, nondominant, temporal lobe. Ictal spitting occurred between 10 to 25 seconds after electrographic seizure onset in the majority of cases. It is possible that ictal spitting is an automatic behavior similar to lip smacking, swallowing, and chewing movements frequently seen in temporal lobe seizures.2 Right-hemispheric lateralization may be due to functional disturbances of areas controlling emotional behavior in the nondominant hemisphere.

  1. Carmant L, Riviello JJ, Thiele EA, et al. Compulsory spitting: An unusual manifestation of temporal lobe epilepsy. J Epilepsy 1994; 7: 167-170.
  2. Dantas FG, Yacubian EM, Jorge CL, et al. Clinical and EEG analysis of mesial and lateral temporal lobe seizures. Arq Neuropsiquiatr 1998; 56: 341-349.

Submitted by Mayur Chalia, MD, PGY-1, Department of Neurology, Penn State Milton S. Hershey Medical Center.

Disclosures: Dr. Chalia reports no disclosures.

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