Supplementary motor area (SMA)
The onset and relief of the seizure are quite abrupt. The tonic posturing in this area is unilateral or asymmetric between the left and right hemispheres. A somatosensory aura frequently precedes many large motor and vocal symptoms and most often the affected person is responsive. Motor symptoms: Facial grimacing and complex automatisms like kicking and pelvic thrusting
Vocal symptoms: Laughing, yelling, or speech arrest. Primary motor cortex
The primary motor cortex has jacksonian seizures that spread to adjacent areas of the lobe which often trigger a second round of seizures originating in another cortical area. The seizures are much simpler than those that originate in the SMA and are usually clonic or myoclonic movements with speech arrest. Some dystonic or contralateral adversive posturing may also be present. Medial frontal, cingulate gyrus, orbitofrontal, or frontopolar regions
Motor symptoms of seizures in this area are accompanied by emotional feelings and viscerosensory symptoms. Motor and vocal agitation are similar to that of the SMA with short repetitive thrashing, pedaling, thrusting, laughing, screaming and/or crying. This is some of what can cause the misdiagnosis of a psychological disorder. Dorsolateral cortex
This area does not seem to have many motor symptoms beyond tonic posturing or clonic movements. Contralateral or less commonly ipsilateral head turn and eye deviation are commonly associated with this area as well. Operculum
Many of the symptoms associated with this area involve the head and digestive tract: swallowing, salivation, mastication and possibly gustatory hallucinations. Preceding the seizure the person is fearful and often has an epigastric aura.
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