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Abstract Details

A Descriptive Study of Eye Movements in Versive Seizures
Epilepsy/Clinical Neurophysiology (EEG)
Epilepsy/Clinical Neurophysiology (EEG) Posters (7:00 AM-5:00 PM)
042
To analyze eye movements in versive seizures in focal and generalized epilepsy patients.
Versive seizures are defined as a forced and involuntary turning of the head and eyes in one direction with an associated neck extension, resulting in a sustained unnatural position. Synchrony between head and eye deviation is always seen in epilepsy as they both share a common symptomatogenic zone: the frontal eye fields. There have been very few studies analyzing detailed eye movements during versive seizures as poor video quality was a limiting factor in the past.
We analyzed ictal eye movements of 45 seizures from 30 patients with versive seizure semiology that were admitted to Adult Monitoring Unit (AMU) at University Hospitals Cleveland Medical Center. We only included patients with clear, high-resolution seizure videos and interpretable EEG.
In all patients, eyes moved contralateral to the seizure onset zone and ipsilateral to the head version. Two types of eye movements were seen: saccade and smooth pursuit. Saccades were much more common (90.3%). We classified the eye movements in relation to the head deviation into three types: I) eyes preceding the head; II) head preceding the eyes; III) Eyes and head moving simultaneously. For the saccadic eye movements, 2-3 saccades were needed for the eyes to reach the maximum deviation. Ipsilateral facial muscle contractions were seen on the side of saccade direction. Further data analysis is in progress. 
Version movements have a high lateralizing value in focal epilepsy. We hope that our data will further elucidate the role of eye version as it relates to the rest of seizure semiology. This research on the relationship of eye and head movements during versive seizures will allow for better understanding of underlying physiology.
Authors/Disclosures
Neel Fotedar, MD (University Hospitals Cleveland Medical Center)
PRESENTER 		Dr. Fotedar has received research support from NINDS.
Prasannakumar K. Gajera, MBBS Dr. Gajera has nothing to disclose.
Nataliya Pyatka, MD Dr. Pyatka has nothing to disclose.
Salam M. Nasralla, MD (King Faisal Specialist Hospital and Research Center) Dr. Nasralla has nothing to disclose.
Takafumi Kubota, MD (Department of Epileptology, Tohoku University School of Medicine) Dr. Kubota has nothing to disclose.
Guadalupe Fernandez-Baca Vaca, MD Dr. Fernandez-Baca Vaca has nothing to disclose.
Aasef Shaikh, MD Dr. Shaikh has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acorda.