Localising and Lateralising Value of Language Manifestations During Partial Seizures

GIAGANTE, ODDO, SOLIS, MELCON, SILVA, CONSALVO, D`ALESSIO, CENTURION, SAIDON, SALGADO, KOCHEN

Paris

Congreso; 26th International Epilepsy Congress; 2005

Purpose: To evaluate the localising and lateralising value of ictal and postictal language manifestations observed during partial seizures. Methods: Ictal video-EEG recordings obtained between October 2001 and October 2004 have been reviewed. Language manifestations observed during seizures were classified as: ictal vocalisation without speech quality (IV), normal ictal speech (NIS), abnormal ictal speech (AIS), and abnormal postictal speech (APS). According to the site of origin, seizures were classified in temporal seizures (TS), and in extra-temporal seizures (EXS); and according to the side of onset, in right and left seizures. We analysed ictal and postictal language manifestations and their relationship with the site (TS or EXS) and side (right or left hemisphere) seizure origin, to establish their localising and lateralising value. Logistic regression was used for statistical analysis. Results: Language manifestations were observed in 135 seizures, corresponding to 54 consecutive right handed patients. Ictal vocalisation (IV) was observed in 48.1% seizures: 72.5% belonged to EXS group (p=0.000), without lateralising value; NIS occurred in 28.1% seizures: 84.2% corresponded to TS group (p=0.000), and when considering the side of onset, 84.2% corresponded to seizures of the right hemisphere (p=0.000); AIS was observed in 16.3% seizures, without localising or lateralising value; APS occurred in 37% seizures: 78% corresponded to TS group (p=0.004), and 82% corresponded to seizures of the left hemisphere (p=0.000). Conclusion: Language manifestations are a frequent symptom in partial  seizures and are a useful tool that contributes to the identification of the epileptogenic zone (EZ). Ictal vocalisation, NIS and APS were significantly associated with EXS, right TS and left TS, respectively.