Semiology of hypermotor (hyperkinetic) XXXX .

@entity1 @entity410 @entity302 @entity4940
BACKGROUND: @entity410 ( @entity410 ) consist of complex movements involving proximal segments of the limbs and trunk that appear violent and inappropriate for the situation. METHODS: We analyzed hypermotor @entity410 videos in @entity410 -free @entity1 (Engel class I) following resective @entity302 surgery. After completion of video analysis, we reviewed EEG and neuroimaging data. RESULTS: Search of our @entity302 surgery database yielded 116 @entity1 classified as having hypermotor @entity410 between 1996 and 2013. From this subset, 17/31 (55%) @entity1 had been @entity410 -free for >6months (mean follow-up: 3.3years). Mean @entity410 duration was 35s (range: 6-91s), of which the HM phase lasted a mean of 22s (range: 3-53s). In 16 @entity1 (95%), hypermotor activity was seen at or within 10s of clinical @entity410 onset. Type I semiology occurred in 6 @entity1 , type II semiology in 10 @entity1 , and 1 @entity1 exhibited features of both. Type I and type II semiologies were noted in @entity1 who had frontal lobe as well as extrafrontal resections. Nonversive head and body turning occurred in 10 @entity1 (ranging from 90   to 270  ) which was ipsilateral to the side of resection in all @entity1 and seen both in frontal and extrafrontal resections. Six out of eleven @entity1 with abnormal MRI and 4/6 @entity1 with nonlesional MRI underwent invasive EEG evaluation. Eight @entity1 (47%) had frontal lobe resection, 4/17 (23%) @entity1 had temporal lobe resection, and one @entity1 each had parietal lobe, insular, temporoparietooccipital, or motor sparing resection; 1 @entity1 had functional hemispherectomy. CONCLUSION: Hypermotor semiology typically occurs at or within 10s after @entity410 onset. Ipsilateral head/body turning appears to be of lateralizing value whereas asymmetry of limb movement was not lateralizing. Hypermotor semiology is most often seen in @entity4940 but may occur in @entity410 arising from other locations.
