Abstracts

Auras (Greek, [ldquo]breeze[rdquo]) have been defined as [ldquo]that portion of a seizure which occurs before consciousness is lost and for which memory is retained afterwards.[rdquo] Aura semiology may help reveal the localization of pathology (Fried [italic]et al.[/italic] 1995). However, aura epidemiology in large series of patients undergoing temporal lobectomy as well as the response of the auras to surgical treatment is unclear. We retrospectively analyzed the case records of 182 patients undergoing temporal lobectomy for medically intractable epilepsy at our institution.
Patient age ranged from 7 to 59. Frequency and type of auras pre-, 3 months and 1 year after temporal lobectomy were analyzed. Patients without adequate follow-up and/or aura descriptions were excluded (remaining n=161). Auras were divided into one of the following 6 groups: rising epigastric, olfactory/gustatory, experiential, auditory, fear, and other. [ldquo]Other[rdquo] included vague auras of dizziness, somatosensory auras (tingling), and indescribable auras.
Frequency of auras pre-operatively was 74%. 19% of patients had multiple types of auras. Of defined auras, the most common type was rising epigastric (25% of patients) followed by olfactory/gustatory (12%), experiential (12%), fear (12%), and auditory (4%). Postoperatively, auras were much reduced (28% at 3 months and 26% at 1 year). When auras persisted, surgery occasionally altered the type(s) of aura (e.g. rising epigastric aura was gone but fear aura remained). The reduction in aura frequency after surgery was greatest for olfactory and experiential auras and least for auditory auras (Table).
These data begin to define the epidemiology of auras in a large surgical series and demonstrate that specific types of auras may be independently affected by surgical treatment. Further analysis of these data may help elucidate the anatomic substrate of particular aura types.[table1]