Seizure-associated aphasia has good lateralizing but poor localizing significance.

Abstract:

OBJECTIVE:To investigate the occurrence of ictal and postictal aphasia in different focal epilepsy syndromes. METHODS:We retrospectively analyzed the video-electroencephalographic monitoring data of 1,118 patients with focal epilepsy for seizure-associated aphasia (SAA). Statistical analysis included chi-square analysis and Fisher's exact test. RESULTS:We identified 102 of 1,118 patients (9.1%) in whom ictal or postictal aphasia (SAA) was part of their recorded seizures (n = 59 of 102; 57.8%) or who reported aphasia by history (n = 43; 42.2% only reported aphasia by history). Postictal aphasia was present in 18 patients (30.5%). Six of the 59 patients had both ictal and postictal aphasia (10.2%). SAA occurred either with left hemisphere seizure onset or with seizures spreading from the right to the left hemisphere. SAA was most common in patients with parieto-occipital epilepsy (10.9%; five of 46 patients), followed by patients with temporal (6.7%; 28 of 420 patients), focal (not further localized; 4.8%; 22 of 462 patients), and frontal epilepsy (2.1%; four of 190 patients; p = 0.04). SAA was more common in parieto-occipital epilepsy than in frontal epilepsy (p = 0.02). In contrast, there was no significant difference in SAA between temporal and parieto-occipital epilepsy (p = 0.36). SIGNIFICANCE:SAA has a high lateralizing but limited localizing value, as it often reflects spread of epileptic activity into speech-harboring brain regions.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Loesch AM,Steger H,Losher C,Hartl E,Rémi J,Vollmar C,Noachtar S

doi

10.1111/epi.13835

subject

Has Abstract

pub_date

2017-09-01 00:00:00

pages

1551-1555

issue

9

eissn

0013-9580

issn

1528-1167

journal_volume

58

pub_type

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