Ictal swearing: a case series and review

Abstract

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]

Ictal Swearing as a Lateralizing Value for the Dominant Hemisphere in Temporal Lobe Epilepsy

“…Ictal swearing is more common among males, with lateralization to the non-dominant hemisphere. 2,4,6 However, Massot-Tarrús et al…”

“…4 This implies a different neurophysiological process between ictal swearing and ictal speech. 2,5 Ictal speech results from activation or inhibition of language cortical function, whereas the hypothesized mechanism of ictal swearing is the dysregulation of emotional and behavioral function. 4 In this context, limbic frontal-temporal networks can produce ictal swearing.…”

“…Ictal swearing, a culturally taboo offensive utterance 1 is a rare manifestation in epilepsy patients, [2][3][4] and its pathophysiology and localizing value of ictal swearing are unclear, although a variety of automatisms, including ictal speech, are lateralizing signs for the non-dominant hemisphere. [1][2][3][4][5] Herein, we report a patient with ictal swearing, with ictal discharges on the temporal lobe of the dominant hemisphere, confirmed by video electroencephalography (EEG) monitoring.…”

Ictal Forced Repetitive Swearing in Frontal Lobe Epilepsy: Case report and review of the literature

“…Generally men swear more than women. Men with epilepsy might swear during seizures more than women with epilepsy (Birca et al, 2013).…”

“…Recently, the largest case series of ictal swearing has been published that reviewed two old case reports of ictal swearing and presented 8 new cases. Results indicated that ictal swearing occurs more commonly in male subjects and lateralizes to the non-dominant hemisphere, but has poor localization value, arising either from the frontal, parietal, temporal or occipital lobes in different patients (Birca et al, 2013). Another case report of ictal swearing and aggression in FLE also lateralizes to the non-dominant hemisphere (Shih et al, 2009).…”