Ictal flatulence: seizure onset in the nondominant hemisphere.

We describe the case of a 45-year-old woman with frequent simple partial seizures consisting mainly of autonomic manifestations including flatulence. The ictal onset and interictal EEG epileptiform abnormalities were localized to the right frontotemporal region. This localization was supported by structural brain imaging showing recurrence of a right frontotemporal oligodendroglioma with involvement of the insula. We therefore suggest that ictal flatulence is one of several autonomic and gastrointestinal symptoms and signs that may be used clinically in lateralizing to the nondominant hemisphere.