Ictal kissing: Review of literature and report of 5 cases

Epileptic Disord. 2024 Apr 1. doi: 10.1002/epd2.20208. Online ahead of print.


Ictal kissing (IK) is a rare type of automatism observed during epileptic seizures. Despite its uncommon occurrence, understanding the underlying mechanisms, the role of emotions, and the level of consciousness during seizures with IK is essential in providing a comprehensive understanding of epilepsy. We describe five cases (.13%) of IK after performing a retrospective analysis of 3794 long-term, ictal video-EEGs from an epilepsy monitoring unit in Mumbai, India. Our patients with drug-resistant epilepsy showed IK had a wide epileptogenic zone. We discuss the current hypotheses on the mechanisms behind IK, the involvement of temporal lobe structures, and the implications of awareness during seizures. The review concludes by suggesting future directions for research to elucidate the complex phenomenon of IK further.

Keywords: Etiology: hippocampal sclerosis or atrophy; Localization: mesial temporal; Phenomenology: kissing (ictal); Syndrome: focal non‐idiopathic mesio temporal (MTLE with or without HS); TLE; frontotemporal network; ictal spitting; propagation network zone; rare seizure manifestation.