Ictal Paraphasia: A Rare Ictal Manifestation of Dominant Temporal Lobe Epilepsy
Abstract number :
2.001
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2021
Submission ID :
1826356
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:53 AM
Authors :
Jorge Barragan, MD - Hospital Universitario Fundación Santa Fe de Bogotá; Julian Mancera - Neurology - Hospital Universitario Fundación Santa Fe de Bogotá; Paula Martinez - Neurology - Hospital Universitario Fundación Santa Fe de Bogotá; Carlos Mayor - Neurology - Hospital Universitario Fundación Santa Fe de Bogotá
Rationale: Speech disturbances are a known manifestation of focal onset seizures. Different patterns of ictal language disturbances have been described, including positive symptoms such as vocalizations (sounds without speech quality) or production of normal speech, and negative symptoms including anterior and posterior aphasia, dysarthria-arthria, speech arrest, dysphasias (receptive, expressive, isolated paraphasia and isolated anomia) and non-identifiable speech. These speech manifestations are mostly related with temporal lobe epilepsy, being aphasia associated with dominant hemisphere seizures, and ictal verbalization, with normal or abnormal syntax of the verbal output, lateralizing to non-dominant hemisphere.
Methods: We describe a case-report.
Results: A 73-year-old woman presented to our Epilepsy Clinic with frequent self-limited episodes described as loss of awareness, confusion and semantic/verbal, phonemic paraphasias, lasting a few seconds. Video-EEG monitoring revealed ictal spikes over a rhythmic, evolving delta activity in the left anterior and mid temporal region during twelve typical events. MRI of the brain revealed a hyperintense lesion in the anterior lobe in T2-weighted sequences with nodular central appearance. A partial resection of the lesion was performed. Pathology revealed IDH-R132H negative infiltrating III grade glioma. At 4 months from the diagnosis, the patient remains seizure free, with no sequalae.
Conclusions: In conclusion, paraphasia as an ictal manifestation in a patient with a left temporal glioma was successfully treated with a classical left amigdalo-hypocampectomy with extension to the temporal pole. Ictal paraphasia in this case, lateralized to the dominant temporal lobe and was a clinical manifestation of tumor-related epilepsy, not before described in the literature.
Funding: Please list any funding that was received in support of this abstract.: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Neurophysiology