Ictal speech automatism reproduced by activation procedures

Driver, M. V.; Falconer, Murray A.; Serafetinides, E. A.

doi:10.1212/wnl.14.5.455

Cited by 25 publications

(10 citation statements)

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“…The pathophysiology of ictal speech automatism remains doubtful 12,13 and is further complicated for FLISA by uncertainties regarding the functional anatomy of normal foreign language processing. Indeed, the brain regions involved in the use of the second language is a matter of debate.…”

Section: Resultsmentioning

confidence: 99%

Foreign language ictal speech automatisms in nondominant temporal lobe epilepsy

Montavont¹,

Kahane²,

Guénot³

et al. 2008

Neurology

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Section: Resultsmentioning

confidence: 99%

Foreign language ictal speech automatisms in nondominant temporal lobe epilepsy

Montavont¹,

Kahane²,

Guénot³

et al. 2008

Neurology

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“…Even though complex co-ordinated sensori-motor activities are maintained, many of which depend upon acquired neuronal patterns of speech or behaviour, judgement is impaired and speech or behaviour is usually not appropriately related to the immediate environment." In the same year, Driver et al (6) reported speech automatisms in a seizure induced by electrical stimulation of the right amygdala, occurring while discharges remained localized to the right temporal lobe, and suggested that speech automatisms were due to release of the dominant hemisphere.…”

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confidence: 99%

Ictal Oroalimentary Automatisms with Preserved Consciousness: Implications for the Pathophysiology of Automatisms and Relevance to the International Classification of Seizures

et al. 1998

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Summary:A patient showing seizures presenting ictal automatisms with preserved consciousness is reported. A 30-yearold, right-handed man with normal development and without family history of epilepsy was referred for surgical treatment of epilepsy. At 15 he began to have seizures, starting with an epigastric aura, occasionally developing automatisms (lipsmacking, chewing), sometimes followed by tonicxAonic convulsions. At the time of referral, he averaged six convulsive seizures per year and one nonconvulsive per week. His sleep EEG showed sharpened slow activity over the right anterior quadrant magnetic resonance imaging (MRI) showed a benign lesion in the mesial aspect of the right occipital lobe. Simultaneous video monitoring and intracranial EEG with subdural strips recording from the right temporal and occipital lobes was undertaken. During one seizure, he had pronounced oroalimentary automatisms while holding a conversation with a technician, answering her questions, and explaining details of his seizures. Memory of this event was preserved. At seizure onset, spike activity was seen at the mesial occipital strips. At midseizure, high-voltage sharpened delta was seen throughout the right hemisphere. Left-sided scalp electrodes remained relatively uninvolved. The lesion, a dysembryoplastic neuroepithelial tumour was removed. Surgery was followed by abolition of seizures described. Because it is agreed that complex partial seizures require impaired consciousness, a history of automatisms with retained consciousness usually suggests nonepileptic attacks. This case suggests that automatisms in epileptic seizures can take place with minimal loss of consciousness, particularly if there is widespread but unilateral involvement. The need for a revision of the International Classification is suggested. Key Words: Simple partial seizure-Complex partial seizure-International Classification of Seizures-Consciousness-Epilepsy surgery.The pathophysiology of ictal automatism and impairment of consciousness in epilepsy is poorly understood. Ictal automatism is regarded as a consequence of impaired consciousness, and both unconsciousness and automatisms are major manifestations of complex partial seizures (1). The perceived relevance of these symptoms to the diagnosis and classification of partial seizures has fluctuated over the years and has been a long-standing source of controversy (2). In the latest revised classification of epileptic seizures ( 3 ) , impairment of consciousness was considered as the key feature in the distinction between simple and complex partial seizures. According to this classification, consciousness is always impaired in complex partial seizures and, in addition, automatic

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“…There were two possible explanations of this lateralization pattern: either ictal speech in L2 results from release of the dominant hemisphere from the inhibitory action of the non-dominant one, or ictal speech results directly from overactivation of the non-dominant hemisphere. 9 According to these hypotheses, the brain systems involved in L2 ictal speech, were delineated by combined functional MRI during bilingual tasks and ictal - interictal single-photon emission computed tomography in a patient who presented L2 ictal speech productions. These analyses showed that the networks activated by the seizure and those activated by L2 processing intersected in the right hippocampus.…”

Section: Discussionmentioning

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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Ictal speech automatism reproduced by activation procedures

Cited by 25 publications

References 0 publications

Foreign language ictal speech automatisms in nondominant temporal lobe epilepsy

Foreign language ictal speech automatisms in nondominant temporal lobe epilepsy

Ictal Oroalimentary Automatisms with Preserved Consciousness: Implications for the Pathophysiology of Automatisms and Relevance to the International Classification of Seizures

Unusual Ictal Foreign Language Automatisms in Temporal Lobe Epilepsy

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