title: Aphasic seizures in patients with temporopolar and anterior temporobasal lesions: a video-EEG study.
abstract: Studies of patients with temporal lobe epilepsy provide few descriptions of seizures that arise in the temporopolar and the anterior temporobasal brain region. Based on connectivity, it might be assumed that the semiology of these seizures is similar to that of medial temporal lobe epilepsy. However, accumulating evidence suggests that the anterior temporobasal cortex may play an important role in the language system, which could account for particular features of seizures arising here. We studied the electroclinical features of seizures in patients with circumscribed temporopolar and temporobasal lesions in order to identify specific features that might differentiate them from seizures that originate in other temporal areas. Among 172 patients with temporal lobe seizures registered in our epilepsy unit in the last 15 years, 15 (8.7%) patients had seizures caused by temporopolar or anterior temporobasal lesions (11 left-sided lesions). The main finding in our study is that patients with left-sided lesions had aphasia during their seizures as the most prominent feature. In addition, while all patients showed normal to high intellectual functioning in standard neuropsychological testing, semantic impairment was found in a subset of 9 patients with left-sided lesions. This case series demonstrates that aphasic seizures without impairment of consciousness can result from small, circumscribed left anterior temporobasal and temporopolar lesions. Thus, the presence of speech manifestation during seizures should prompt detailed assessment of the structural integrity of the basal surface of the temporal lobe in addition to the evaluation of primary language areas.
authors: Epilepsy Unit, Department of Neurology, Hospital Ruber Internacional, Madrid, Spain. Electronic address: rtoledano@ruberinternacional.es.
authors: Rafael
authors: R
authors: Toledano
authors: Adolfo
authors: A
authors: Jiménez-Huete
authors: Irene
authors: I
authors: García-Morales
authors: Pablo
authors: P
authors: Campo
authors: Claudia
authors: C
authors: Poch
authors: Bryan A
authors: BA
authors: Strange
authors: Antonio
authors: A
authors: Gil-Nagel
mesh_terms: D000293:Adolescent; D000328:Adult; D001037:Aphasia / Q000175:diagnosis / Q000209:etiology*; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis / Q000209:etiology*; D014741:Video Recording
keywords: Aphasia; Basal temporal language area; Seizures; Temporal lobe epilepsy; Video-EEG