title: Ictal speech and language dysfunction in adult epilepsy: Clinical study of 95 seizures.
abstract: OBJECTIVE
  To analyze the semiological characteristics of the language and speech disorders arising during epileptic seizures, and to describe the patterns of language and speech disorders that can predict laterality of the epileptic focus.
  
  
  METHODS
  This study retrospectively analyzed 95 consecutive videos of seizures with language and/or speech disorders in 44 patients admitted for diagnostic video-EEG monitoring. Laterality of the epileptic focus was defined according to electro-clinical correlation studies and structural and functional neuroimaging findings. Language and speech disorders were analyzed by a neurologist and a speech therapist blinded to these data.
  
  
  RESULTS
  Language and/or speech disorders were subdivided into eight dynamic patterns: pure anterior aphasia; anterior aphasia and vocal; anterior aphasia and "arthria"; pure posterior aphasia; posterior aphasia and vocal; pure vocal; vocal and arthria; and pure arthria. The epileptic focus was in the left hemisphere in more than 4/5 of seizures presenting with pure anterior aphasia or pure posterior aphasia patterns, while discharges originated in the right hemisphere in almost 2/3 of seizures presenting with a pure vocal pattern. No laterality value was found for the other patterns.
  
  
  CONCLUSIONS
  Classification of the language and speech disorders arising during epileptic seizures into dynamic patterns may be useful for the optimal analysis of anatomo-electro-clinical correlations. In addition, our research has led to the development of standardized tests for analyses of language and speech disorders arising during seizures that can be conducted during video-EEG sessions.
authors.affiliation: Neurology department, Bicêtre hospital, Assistance publique-Hôpitaux de Paris (AP-HP), 94275 Paris, France; Paris-Sud university, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Dussaule
authors.affiliation: Neurology department, Bicêtre hospital, Assistance publique-Hôpitaux de Paris (AP-HP), 94275 Paris, France; Paris-Sud university, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Cauquil
authors.affiliation: Neurology department, Bicêtre hospital, Assistance publique-Hôpitaux de Paris (AP-HP), 94275 Paris, France; Paris-Sud university, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Flamand-Roze
authors.affiliation: Paris-Sud university, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Neurophysiology and epilepsy unit, Bicêtre hospital, Assistance publique-Hôpitaux de Paris (AP-HP), 94275 Paris, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Gagnepain
authors.affiliation: Paris-Sud university, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Neurophysiology and epilepsy unit, Bicêtre hospital, Assistance publique-Hôpitaux de Paris (AP-HP), 94275 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Bouilleret
authors.affiliation: Neurology department, Bicêtre hospital, Assistance publique-Hôpitaux de Paris (AP-HP), 94275 Paris, France; Paris-Sud university, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Inserm U788, 94275 Le Kremlin-Bicêtre, France.
authors.forename: C
authors.initials: C
authors.lastname: Denier
authors.affiliation: Neurology department, Bicêtre hospital, Assistance publique-Hôpitaux de Paris (AP-HP), 94275 Paris, France; Paris-Sud university, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France. Electronic address: pascal.masnou@aphp.fr.
authors.forename: P
authors.initials: P
authors.lastname: Masnou
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000150:complications / Q000523:psychology; D004827:Epilepsy / Q000150:complications* / Q000523:psychology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007806:Language Disorders / Q000209:etiology* / Q000523:psychology*; D008297:Male; D012189:Retrospective Studies; D012640:Seizures / Q000150:complications* / Q000523:psychology*; D013064:Speech Disorders / Q000209:etiology* / Q000523:psychology*; D055815:Young Adult
keywords: Aphasia; Epilepsy semiology; Epileptic focus; Focal seizures; Video–EEG use in epilepsy