The authors evaluate the clinical and electrophysiological findings of non-invasive and invasive video- EEG monitoring in three epileptic patients with ictus emeticus. They evaluated a total of 14 seizures with this symptom, 12 with non-invasive and two with invasive video EEGmonitoring. In all patients secondary epilepsy of the temporal lobe on the right side was involved. In two of three patients who had invasive EEG examination the onset of seizures in the right hippocampus was proved. Ictus emeticus in non-invasive videoEEG monitoring was associated with ictal discharge in the right sphenoidal electrode (Sp2) and temporal and paracentral scalp contacts on the right (T4, C4, T2). In invasive videoEEG in both seizures during ictus emeticus paroxysmal epileptic activity in the amyg- daloid nucleus and hippocampus on the right is present as well as in the lateral neocortical structures on the right (gyrus temporalis superior, gyrus temporalis medius). In one seizure during this pheno- menon ictal activity beyond the mentioned structures is present also in the gyrus temporalis inferior and in the fronto-orbital cortex on the right side. The anterior cingulum and lateral prefrontal cortex (area 9) are not included in the ictal discharge during the ictus emeticus. Ictus emeticus was observed in 2.6% of all monitored epileptic patients and 3.5% of all patients with epilepsy of the temporal lobe. It was recorded in the investigated patients in almost 42% partial epileptic seizures. Ictus emeticus can be considered a reliable lateralizing symptom in epilepsy of the temporal lobe which corresponds with affection of the dextrolateral or non-dominant temporal lobe resp. Probably there is no critical site in the cortex responsible for the vomiting reflex. Consistent with data in the literature the authors draw attention to the role of the dextrolateral fronto-orbito-insulo-operculo-temporal circle in the genesis of this rare ictal phenomenon. The presented results thus may demonstrate a certain functional hemi- spheric asymmetry in the control of vegetative functions.

        Key words: epilepsy, ictus emeticus, temporal lobe, lateralizing phenomenon, non-dominant hemisphe- re