Prolonged and monosymptomatic dysphasic status epilepticus

Abstract

Dysphasic seizures are an infrequent form of epilepsy, and their serial appearance as a partial status epilepticus is quite exceptional. The young patient reported here had a partial dysphasic status epilepticus of 3 weeks' duration without other temporal lobe seizures. Simultaneous serial electroencephalograms, tape recordings of the seizures, and repeated neuropsychologic ictal examinations permitted studies of increased impairment of neuropsychologic function on testing and the appearance of new irritative discharges on encephalography.

Dysphasia Accompanied by Periodic Lateralized Epileptiform Discharges.

“…The long duration of the dysphasia, approximately a few weeks, was compatible with status epilepticus, and PLEDshave been recognized to represent status epilepticus on electroencephalograph (6). Epileptic dysphasia is a rare clinical condition (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), and the present case is noteworthy because of the prolonged dysphasia with persistent PLEDswhich persisted throughout the recording time. Although Wells CR (19) reported a case of epileptic dysphasia and PLEDsappeared transiently in that case, noneof the previous cases of epileptic dysphasia were accompanied by persistent PLEDsas the present case.…”

De Novo Aphasic Status Epilepticus

“…In most cases previously described, the patients were known to have epilepsy (6)(7)(8)(9) or have had other concurrent seizure types at presentation (6,9-11). In other cases, there has been a known predisposing factor for seizures at presentation (2,7,10, 12,13) that would have facilitated the diagnosis of aphasic status.…”

“…They thought that in some cases, the patient did not speak or was not adequately tested (7,11) during the seizure, and consciousness may have been impaired (1 1). In others, due to lack of convincing correlation of the aphasia with the EEG, the aphasia may have been the result of cerebral infarction or Todd's phenomenon (6,7,10,11). We propose the following modification of Rosenbaum' s criteria for establishing epileptic aphasia:…”

Aphasic Status Epilepticus

“…Cases of status epilepticus characterized by speech impairment, particularly in the form of aphasia, speech arrest or vocalization, have been pointed out for a con siderable time [Penfield and Jasper, 1954;Critchley, 1960;Serafetinides and Falconer, 1963], Nevertheless, reports with aphasia as the sole manifestation of status epilepticus are quite rare [De Pasquet et al, 1976;Ham ilton and Matthews, 1979;Dinner et al, 1981;Marrosu et al, 1983;Rosenbaum et al, 1986;Knight and Cooper, 1986]. Here we present the clinical and EEG observation of a patient suffering from aphasic seizures which gave way to a prolonged aphasic status epilepticus.…”