Localization of orgasmic seizures (aura)

Janszky J et al. Orgasmic aura originates from the right hemisphere Neurology 2002; 58:302-304. The authors reviewed 2 new cases and 22 already published. Among 15 with unilateral eeg foci, 13 (87%) had right and 2 (13%) had left hemisphere focus. The lesions included right temporal AVM, 3 had right postcentral parasaggittal focus. Authors comment on the rarity of auras have lateralizing value and this being an exception among epilepsies. Reviewing the chart, several patients had left hand or leg jerking, ictal speech, sitting, automatism, a sensation of fear. Authors believe amygdala is important, but that parasaggittal cases are due to stimulation of the cortical areas important for genital sensation.