Ictal movements mimicking Islamic praying rituals: localizing value in a series of 12 patients

- Ictal praying is a rare automatism.
- It is a seizure sign having localizing and lateralizing values.
- This automatism points to right temporal ictal activity.
- Therefore, this automatism has significance especially for epilepsy surgical candidates.

The aim of this study was to determine the lateralizing value of the ictal praying gesture and of ictal religious speech in patients who are candidates for epilepsy surgery. We retrospectively searched video/EEG data of 1430 patients who were evaluated at an epilepsy center from 1999 to 2014. Twelve patients were found to have demonstrated ictal praying during their complex partial seizures. Among all patients, the ictal focus was in the right temporal region. Ictal behavior simulating prayer, which includes both hands as in the Islamic ritual tradition is a rare automatism that lateralizes the ictal focus.