Does the patient's hand hold the key to preventing secondary generalization in mesial temporal lobe epilepsy?

Fifty-eight out of 171 patients (34%) exhibited ictal DP, of which 91.5% were always unilateral and contralateral to the operated side. DP was related to shorter seizures (p = 0.007) and a much lower likelihood of the seizure evolving to GTCS (p = 0.001), even during AED withdrawal (p = 0.002). There was no association between DP and prognosis regarding seizure control as the result of the surgical resection, either in patients with shorter or in those with longer period of follow-up. Our data support the hypothesis that DP reflects a brain network activation that helps avoid GTCS, even during AED withdrawal.