Postictal Aphasia and Paresis: A Clinical and Intracerebral EEG Study

Adam, Christine; Adam, Claude; Rouleau, Isabelle; Saint‐Hilaire, Jean‐Marc

doi:10.1017/s0317167100051970

Cited by 37 publications

(20 citation statements)

References 27 publications

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“…It is interesting to note that persistent aphasia was not necessarily associated with frequent electrographic seizures. One can speculate that either ongoing electrical seizure activity not detected on scalp electrodes (Hirsch et al., 2001) or lingering postictal inhibition (Adam et al., 2000) might lead to persistent clinical symptoms in these patients.…”

Section: Discussionmentioning

confidence: 99%

Aphasic status epilepticus: Electroclinical correlation

et al. 2011

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Summary Purpose: Aphasic status epilepticus (ASE) in otherwise awake patients is a rare phenomenon. We present a series of nine consecutive patients with ASE to characterize clinical, electrophysiologic, and imaging findings. Methods: Nine patients in ASE were identified between July 2006 and December 2009 at our institution. Each was evaluated by the neurology service and monitored with video‐electroencephalography (EEG) for at least 24 h. Thorough, repeated language testing was correlated with EEG findings. Key Findings: All nine patients were right‐handed with subacute or chronic left hemispheric lesions on magnetic resonance imaging (MRI). All patients had mixed aphasia, three presenting with persistent aphasia from onset and six with episodic speech impairment, which became persistent in five of the six. The initial 30‐min EEG demonstrated electrographic seizure in only five patients (56%), despite the presence of aphasia during the recording. Left hemispheric periodic lateralized epileptiform discharges (PLEDS) were seen in two patients, and left hemispheric slowing in two patients. Continuous video‐EEG monitoring confirmed electrographic seizure activity in all nine patients. Peak electrographic seizure frequency varied from continuous to once every 2 h and was not associated with fluctuations in the speech deficit. EEG seizures resolved abruptly in three patients and gradually over up to 4 days in six patients. Clinical improvement was delayed in eight of the nine patients, and four patients retained some aphasia at discharge, 2–4 days after EEG seizure resolution. Significance: Standard EEG is sensitive for detection of abnormalities in the dominant hemisphere in patients with ASE. However, continuous EEG is necessary to confirm the diagnosis and monitor treatment, since clinical symptoms do not correlate with electrographic seizure activity and do not provide sufficient information to guide treatment decisions.

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Section: Discussionmentioning

confidence: 99%

Aphasic status epilepticus: Electroclinical correlation

et al. 2011

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“…The mechanism underlying postictal aphasia (PA) may be related to active inhibition or postictal exhaustion induced by ictal activities in language areas and their connections. 12 The literature is relatively scarce in substantiating the prevalence of PA in both monolingual and bilingual patients. In one series of 68 patients with temporal lobe epilepsy (TLE), PA was found in 51.6% and correctly lateralized the seizure onset to the dominant hemisphere in 81.3%.…”

Section: Patterns Of Language Recovery In Multilingual Patientsmentioning

confidence: 99%

Pearls & Oy-sters: Selective postictal aphasia

Aladdin¹,

Snyder²,

Ahmed³

2008

Neurology

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“…Anatomically, speech areas are located in the dominant frontal and temporal lobe . Not surprisingly, SAA has been reported in frontal and temporal epilepsies (Table ) . However, these studies included mostly patients with temporal and frontal epilepsies.…”

Section: Summary Of Previously Reported Patients With Saamentioning

confidence: 99%