Abstracts

Rationale: Foreign Language Ictal Speech Automatism (FLISA) is a rare ictal sign that has been hitherto reported in five unilingual patients, all right handed males suffering from right temporal lobe epilepsy (TLE), only one of whom has benefited from an intracerebral EEG investigation. Methods: We report three unilingual French patients who consistently presented English spoken ictal speech automatisms and were investigated with intracerebral EEG recordings. Results: All three patients were right handed males suffering from non dominant TLE originating in the right amygdala, specifically. However, FLISA only occurred when the ictal EEG discharge spread to the ipsilateral temporal neocortex or frontal operculum. In addition, FLISA were emotionally salient, referring to the patient’s parents or to the intensity of the ongoing seizure. Conclusions: Our findings, together with previously published data, suggest that FLISA are more likely to occur in male patients suffering from non dominant amygdala onset seizures, an observation that might reflect the sexual dimorphism observed in the right amygdala during emotional processing.