Foreign language ictal speech automatisms in nondominant temporal lobe epilepsy

Montavont, Alexandra; Kahane, Philippe; Guénot, Marc; Ryvlin, Philippe

doi:10.1212/01.wnl.0000334934.59069.47

Cited by 8 publications

(6 citation statements)

References 35 publications

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“…Foreign language ictal speech automatisms are more likely to occur in men with nondominant amygdala onset seizures, an observation that might reflect the sexual dimorphism observed in the right amygdala during emotional processing. 11 These findings were different from sex distribution with our report. However, one of the case report found theforeign language ictal speech automatisms in teenage girl.…”

Section: Discussioncontrasting

confidence: 99%

Unusual Ictal Foreign Language Automatisms in Temporal Lobe Epilepsy

Soe

Lee

2014

J Epilepsy Res

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The distinct brain regions could be specifically involved in different languages and the differences in brain activation depending on the language proficiency and on the age of language acquisition. Speech disturbances are observed in the majority of temporal lobe complex motor seizures. Ictal verbalization had significant lateralization value: 90% of patients with this manifestation had seizure focus in the non-dominant temporal lobe. Although, ictal speech automatisms are usually uttered in the patient's native language, ictal speech foreign language automatisms are unusual presentations of non-dominent temporal lobe epilepsy. The release of isolated foreign language area could be possible depending on the pattern of ictal spreading of non-dominant hemisphere. Most of the case reports in ictal speech foreign language automatisms were men. In this case report, we observed ictal foreign language automatisms in middle age Korean woman. IntroductionOver 50% of the world's population has been reported to be bilingual (i.e., theoretically presenting equal fluency in two languages). 1The epilepsy affects 1% of the population by age 20 and 3% of the population by age 75.2 Consequently, the epilepsy patients are not uncommon in bilingual population. Among the patients with epilepsy, temporal lobe epilepsy (TLE) is the most common symptomatic partial epilepsy in adolescents and adults. It represents almost two thirds of cases of intractable epilepsy managed surgically. A history of febrile seizures (especially complex febrile seizures) is common in TLE and is frequently associated with mesial temporal sclerosis (the commonest form of TLE). 3Speech disturbances are observed in the majority of temporal lobe complex motor seizures. Types of language disturbances include vocalizations, abnormal speech, ictal speech, and postictal aphasia. With verbal automatism, increased verbal outputs are often linguistically correct, reiterative, and occur spontaneously.5 It is frequently associated with seizures originating in the temporal lobe, arising from the language non-dominant side. 6 Seizure auras occur in many TLE patients and often exhibit features that are relatively specific for TLE but few are of lateralizing value. Automatisms, however, often have lateralizing significance. Careful study of seizure semiology remains invaluable in addressing the search for the seizure onset zone. 3 Our case report of foreign language ictal speech automatisms is a rare ictal sign in temporal lobe epilepsy arising from the nondominant hemisphere. CaseA 45-year-old (right-handed) Korean woman presented an abrupt motionless stare looking, altering her ability to interact with her environment and speak of foreign language. These episodes lasted a few minutes and were preceded by aura (feeling of dream and floating of the body). Furthermore, she did not remember these events during the postictal period. She has been diagnosed as complex partial seizures since 2 nd grade of middle school age. Her seizures came out 2 to 3 times per month on combin...

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Section: Discussioncontrasting

confidence: 99%

Unusual Ictal Foreign Language Automatisms in Temporal Lobe Epilepsy

Soe

Lee

2014

J Epilepsy Res

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“…Our patient is presented as one of these rare cases with two foreign language ictal automatisms (FLISA). Differing from a previous report suggesting that foreign language ictal speech automatisms are more likely to occur in men [8], we observed this seizure pattern in a teenage girl.…”

Section: Discussioncontrasting

confidence: 99%

Two foreign language automatisms in complex partial seizures

Kececi

Değirmenci

Gümüş

2013

Epilepsy & Behavior Case Reports

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Ictal speech manifestations with or without loss of consciousness can frequently occur in TLE in which sometimes the patient may remain responsive, even in conjunction with automatisms. Foreign language ictal speech automatism (FLISA) is a rare ictal sign in temporal lobe epilepsy arising from the non-dominant hemisphere. While our literature review revealed no report of CPSs with two foreign language ictal speech automatisms, we here represented a rare case of a Turkish woman with TLE experiencing two foreign language ictal speech automatisms.

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“…Thus, ictal swearing might be produced by language areas of the dominant hemisphere, which is no longer controlled by the non‐dominant hemisphere. A similar neurophysiological mechanism has been proposed for ictal speech (including ictal speech in a foreign language), a well‐accepted lateralising sign to the non‐dominant hemisphere in temporal lobe epilepsy (Serafetinides and Falconer, 1963; Gabr et al , 1989; Montavont et al , 2008). Indeed, both phenomena require intact articulation derived from the language‐dominant areas.…”

Section: Discussionmentioning

confidence: 61%

Ictal swearing: a case series and review

Birca

Tayah

Saint‐Hilaire

et al. 2013

Epileptic Disorders

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Seizures can manifest with ictal swearing but few studies have investigated the localising value of this epileptic manifestation. In this case series and review of the literature, we attempted to determine whether ictal swearing could help localise the epileptic focus. We review two previously published cases and report eight additional epileptic patients with ictal swearing for whom the epileptic focus was determined based on clinical, structural, electrophysiological, and surgical outcome data. Results indicated that ictal swearing occurs more commonly in male subjects and lateralises to the non‐dominant hemisphere, but has poor localisation value, arising either from the frontal, parietal, temporal or occipital lobes in different patients. We discuss the significance of these findings. [Published with video sequences]

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Foreign language ictal speech automatisms in nondominant temporal lobe epilepsy

Cited by 8 publications

References 35 publications

Unusual Ictal Foreign Language Automatisms in Temporal Lobe Epilepsy

Unusual Ictal Foreign Language Automatisms in Temporal Lobe Epilepsy

Two foreign language automatisms in complex partial seizures

Ictal swearing: a case series and review

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