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  • Title: Speech preservation during language-dominant, left temporal lobe seizures: report of a rare, potentially misleading finding.
    Author: Kaiboriboon K, Parent JM, Barbaro NM, Walker JA, Garcia PA.
    Journal: Epilepsia; 2006 Aug; 47(8):1343-6. PubMed ID: 16922879.
    Abstract:
    PURPOSE: To evaluate the prevalence and mechanism of ictal speech in patients with language-dominant, left temporal lobe seizures. METHODS: We retrospectively reviewed the video-EEG telemetry records for the presence of ictal speech in 96 patients with surgically proven left temporal lobe epilepsy and studied the seizure-propagation patterns in three patients who required intracranial EEG recordings for seizure localization. RESULTS: Ictal speech preservation was observed in five patients. One patient's seizures demonstrated rapid propagation of the ictal discharges to the contralateral temporal area where the seizure evolved, resembling a nondominant temporal lobe seizure. The other two patients had ictal discharges that remained confined to the inferomesial temporal areas, sparing language cortex. CONCLUSIONS: Preservation of speech in complex partial seizures of language-dominant, left temporal lobe origin is rare. Based on intracranial EEG recordings, the likely mechanism underlying this potentially misleading clinical finding is the preservation of language areas due to limited seizure-propagation patterns.
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