Ictal head roll: a seizure semiology from the anterior prefrontal lobe

Gabriela Tantillo, Hernan Nicolas Lemus, Nathalie Jetté, Saadi Ghatan, Fedor Panov, Dina Bolden, Madeline C. Fields

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Longstanding epilepsy can lead to modulation of cortical networks over time and unexpected seizure onset zones. Frontal lobe seizures, in particular, can have diverse semiologies and evolution patterns. We present a male patient with drug-resistant epilepsy secondary to severe traumatic brain injury who underwent bilateral stereo electroencephalography (SEEG) for surgical planning. SEEG localized an ictal circular head roll to the right anterior prefrontal region. This was followed by spread to the left orbitofrontal region and later the left amygdala and hippocampus, at which point a different semiology with behavioral arrest, lip smacking and oral automatisms began. This case, in which an ictal circular head roll was localized to the anterior prefrontal region, demonstrates the complexity of broad seizure networks that develop over time, leading to remote seizure spread.

Original languageEnglish
Pages (from-to)211-218
Number of pages8
JournalEpileptic Disorders
Issue number1
StatePublished - Feb 2022


  • anterior prefrontal region
  • drug-resistant epilepsy
  • ictal circular head
  • stereoelectroencephalography (SEEG)


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