Localization of postictal nose rubbing

Geyer JD, Payne TA, Faught E, et al. Posictal nose rubbing in the diagnosis lateralization and localization of seizures. Neurology 1999; 52: 743-745.

Posticatal nose wipe occurred in 25/50 patients with right TLE and 21/50 patients with left TLE, 90 % with the ipsilateral hand wiping. It occurred in 5/50 patients with frontal epilepsy and not in any patients with generalized epilepsy (0/11) or nonepileptic events (0/100).
Discussion-- author related the nose-wipe to olfactory hallucinations in the aura of patients with TLE and the involvement of the uncus or its connections. About 2 thirds of the patients with postictal nose wiping had tonic stiffening, tonic clonic activity, dystonic posturing, or postictal paresis of the contralateral limb.