Ictal urinary urge:: Further evidence for lateralization to the nondominant hemisphere

Purpose: To determine the lateralizing value of ictal urinary urgency. Methods: A retrospective database search was performed for patients with ictal urinary urgency admitted to the Epilepsy Monitoring Unit at the Cleveland Clinic between 1994 and 2001. Results: Six patients were identified; intracarotid amytal test demonstrated left hemispheric speech dominance in five cases. The sixth patient continued to speak during right temporal seizures. EEG and imaging data supported right temporal or frontotemporal epilepsy in all six cases. Two patients were seizure free after focal right hemispheric resection. Conclusions: Ictal urinary urge appears to be a lateralizing sign for nondominant temporal lobe epilepsy.