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Lee HC, Kim BK, Kang K, Lee WW, Yoo I, Kim YS, Lee JJ. Aphasic Status Epilepticus Associated with Alzheimer's Disease: Clinical and Electrographic Characteristics. J Epilepsy Res 2023; 13:55-58. [PMID: 38223360 PMCID: PMC10783961 DOI: 10.14581/jer.23009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/06/2023] [Accepted: 12/12/2023] [Indexed: 01/16/2024] Open
Abstract
In aphasic status epilepticus (ASE), aphasia is the sole manifestation of seizure in patients with this disorder. Alzheimer's disease (AD) is one of neurological disorders causing ASE. Herein, we report two cases of ASE associated with AD, and discuss their clinical characteristics. Patient 1 presented Broca's aphasia, and patient 2 presented global aphasia during the ictal period. Both patients exhibited atypical ictal electroencephalographic (EEG) patterns, which improved after antiepileptic drug administration. ASE was the presenting symptom of AD in patient 1. ASE can develop at any stage of AD. Alterations in clinical symptoms and EEG patterns after treatment with antiepileptic drug are the key to diagnosis. Prompt diagnosis and treatment are critical for preventing further consciousness dysfunction.
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Affiliation(s)
- Hyoung Cheol Lee
- Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Byung-Kun Kim
- Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Kyusik Kang
- Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Woong-Woo Lee
- Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Ilhan Yoo
- Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Yong Soo Kim
- Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Jung-Ju Lee
- Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
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Jaraba Armas S, Sala‐Padró J, Veciana M, Arroyo P, Pedro J, Mora J, Fernandez M, Camins À, Rodriguez‐Bel L, Falip M. New-onset non-lesional aphasic status epilepticus. Clinical description, diagnostic clues, and treatment algorithm. Acta Neurol Scand 2022; 145:579-589. [PMID: 35130366 DOI: 10.1111/ane.13586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/27/2021] [Accepted: 01/02/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES De novo aphasic status epilepticus (ASE) in patients without a previous history of epilepsy and without cerebral lesions (aphasic NOSE) is rare. The aim of the study is to describe its clinical characteristics, etiologies, and outcome. MATERIALS & METHODS Single-center study including consecutive patients presenting to the emergency department between 2011 and 2019 with acute aphasia, which was finally diagnosed as aphasic NOSE. Subsequent episodes of aphasia (>5 min) were recorded and divided into confirmed ASE and postictal aphasic episodes (non-ASE). Clinical characteristics of the two types of episodes were compared. RESULTS Nineteen patients were included, suffering fifty episodes of epileptic aphasia, episodes per patient 2.6 (range 1-7). Fifteen patients (71.4%) were women, mean age at ASE onset was 66.05 years old (SD 6.3). Nine (47%) patients died, 6 of them (66.7%) during the aphasic episode. Ictal EEG was available in 37 episodes, confirming the diagnosis of ASE in 12 episodes; in 8 episodes, the EEG fulfilled the criteria of possible ASE. The most frequent etiologies were inflammatory and vascular. Comparing ASE with non-ASE episodes, ASE was longer than non-ASE (225 vs 65 h, p .024) and was treated more frequently with BZD (76 vs 24%, p .001) but with a longer delay (22.2 vs 1.5 h, p .06). CONCLUSIONS ASE is a treatable, highly relapsing emergency, with the subsequent relapses ASE or postictal aphasia. EEG is diagnostic in half of the patients, while in others imaging techniques are also useful. Benzodiazepines should be administered. Persistent aphasia, of more than 65 hours' duration, is highly suggestive of ASE.
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Affiliation(s)
- Sonia Jaraba Armas
- Neurology Service Epilepsy Unit Hospital Universitari de Bellvitge‐IDIBELL Universitat de Barcelona, L'Hospitalet de Llobregat Barcelona Spain
- Neurology Department Hospital de Viladecans Barcelona Spain
| | - Jacint Sala‐Padró
- Neurology Service Epilepsy Unit Hospital Universitari de Bellvitge‐IDIBELL Universitat de Barcelona, L'Hospitalet de Llobregat Barcelona Spain
| | - Misericòrdia Veciana
- Neurology Service Neurophysiology Department Hospital Universitari de Bellvitge‐IDIBELL Universitat de Barcelona, L'Hospitalet de Llobregat Barcelona Spain
| | - Pablo Arroyo
- Inpatient Unit Neurology Service Hospital Universitari de Bellvitge‐IDIBELL Universitat de Barcelona, L'Hospitalet de Llobregat Barcelona Spain
| | - Jordi Pedro
- Neurology Service Neurophysiology Department Hospital Universitari de Bellvitge‐IDIBELL Universitat de Barcelona, L'Hospitalet de Llobregat Barcelona Spain
| | - Jaume Mora
- Image Diagnostic Institute (IDI) Nuclear Medicine Department SPECT Unit Hospital Universitari de Bellvitge Image Diagnostic Institute, L'Hospitalet de Llobregat Barcelona Spain
| | - Montserrat Fernandez
- Image Diagnostic Institute (IDI) MRI Unit Hospital Universitari de Bellvitge Image Diagnostic Institute, L'Hospitalet de Llobregat Barcelona Spain
| | - Àngels Camins
- Image Diagnostic Institute (IDI) MRI Unit Hospital Universitari de Bellvitge Image Diagnostic Institute, L'Hospitalet de Llobregat Barcelona Spain
| | - Laura Rodriguez‐Bel
- Image Diagnostic Institute (IDI) Nuclear Medicine Department PET Unit, Hospital de Bellvitge Universitat de Barcelona, L'Hospitalet de Llobregat Barcelona Spain
| | - Mercè Falip
- Neurology Service Epilepsy Unit Hospital Universitari de Bellvitge‐IDIBELL Universitat de Barcelona, L'Hospitalet de Llobregat Barcelona Spain
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Kantzeli A, Brandt C, Tomka-Hoffmeister M, Woermann F, Bien CG. De novo aphasic status epilepticus: Finally making the diagnosis by long-term EEG. Epilepsy Behav Rep 2021; 17:100513. [PMID: 35005597 PMCID: PMC8715158 DOI: 10.1016/j.ebr.2021.100513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/15/2021] [Accepted: 12/02/2021] [Indexed: 11/15/2022] Open
Abstract
Aphasic status epilepticus (SE) is a rare manifestation of non-convulsive SE (NCSE) and may occasionally be under-recognized. We report a 69-year-old male patient with a pre-existing left parietal oligodendroglioma WHO III after two resections and radio-chemotherapy. The patient was left with some word finding difficulties but had no history of overt seizures. He developed aphasic NCSE, which was only detected by long-term electroencephalography (EEG) monitoring. The 24-hour EEG revealed paroxysmal rhythmic theta-delta activity in left posterior regions that propagated to left temporo-parietal areas. Rhythmic activity appeared every 15-30 min and lasted for 10-110 s. Aphasia was continuously present with superimposed short-lasting clinical deteriorations during the day. Magnetic resonance imaging showed peri-ictal edema on diffusion-weighted images in the insula and fronto-parietal cortex, which supported the diagnosis of SE. NCSE persisted for seven months. The patient recovered upon addition of intravenous phenytoin. One should not only consider aphasic SE when language impairment is episodic, but also when there are prolonged manifestations, especially when the typical differential diagnoses have been excluded. Intravenous therapy may be required to terminate NCSE. With this report, we would like to draw attention to aphasic SE as a rare phenomenon that may be difficult to diagnose and delay management in clinical practice.
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Key Words
- ASM, antiseizure medication
- Aphasic status epilepticus
- Benzodiazepines
- CTP, CT-perfusion
- DWI, diffusion-weighted imaging
- EEG, electroencephalography
- FDG-PET, fluorodeoxyglucose positron emission tomography
- FLAIR, Fluid-attenuated inversion recovery
- LPD, lateralized periodic discharges
- MRI, Magnetic resonance imaging
- NCSE, non-convulsive SE
- Oligodendroglioma
- PCV, Procarbazin/Lomustin/Vincristin
- Phenytoin
- Rhythmic theta-activity
- SE, status epilepticus
- Structural focal epilepsy
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Affiliation(s)
- Angeliki Kantzeli
- Department of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany
| | - Christian Brandt
- Department of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany
| | - Maria Tomka-Hoffmeister
- Department of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany
| | - Friedrich Woermann
- Department of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany
- Society of Epilepsy Research, Maraweg 21, 33617 Bielefeld, Germany
| | - Christian G. Bien
- Department of Epileptology (Krankenhaus Mara), Bielefeld University, Medical School, Campus Bielefeld-Bethel, Maraweg 21, 33617 Bielefeld, Germany
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Aphasic status epilepticus after glioma resection: two case reports. Acta Neurochir (Wien) 2021; 163:3109-3113. [PMID: 34477975 DOI: 10.1007/s00701-021-04984-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
Aphasic status epilepticus (ASE) is a subtype of focal nonconvulsive status epilepticus, in which language disturbance is the only objective clinical manifestation. We present two cases of patients who experienced delayed onset of temporal aphasia after the removal of glioma at the language-dominant hemisphere. In both cases, arterial spin labeling was useful for diagnosis and antiepileptic drug was effective. ASE should be considered a cause of persistent aphasia after glioma resection at or near the language area.
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Unterberger I, Trinka E, Ransmayr G, Scherfler C, Bauer G. Epileptic aphasia - A critical appraisal. Epilepsy Behav 2021; 121:108064. [PMID: 34052636 DOI: 10.1016/j.yebeh.2021.108064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/30/2021] [Accepted: 05/10/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Aphasic and other language disturbances occur in patients with epilepsy during and after epileptic seizures. Moreover, the interictal language profile in these patients is heterogeneous, varying from normal language profile to impairment in different language functions. The aim of this paper was to critically review the terms and concepts of ictal language alterations. MATERIAL AND METHOD For this review we performed an extensive literature search on the term "epileptic aphasia" and analyzed the semiology and terminology indicating language-associated seizure symptoms. In addition, we give an overview on EEG, etiology, and brain imaging findings and ictal language disorders. RESULTS In the literature, a plethora of terms indicates language-associated seizure symptoms. Simultaneous Video-EEG monitoring represents the gold standard to correctly classify ictal versus postictal language disturbances and to differentiate aphasic symptoms from speech automatisms. Different rhythmic and periodic EEG patterns associated with ictal language disturbances are recognized. Cerebral magnetic resonance imaging (cMRI) is essential in the diagnosis of seizures and epilepsy. Brain tumors and acute or remote cerebrovascular lesions are the most frequently reported structural etiologies underlying ictal language alterations. However, it has to be recognized that brain imaging may show alterations being the consequence of seizures itself rather than its cause. Functional brain imaging might be informative in patients with inconclusive EEG and MRI findings. Overall, seizure-associated aphasia is reported to have good lateralizing significance. CONCLUSION Various language disturbances are caused by different types of seizures, epilepsies and underlying etiologies. In the clinical context, simultaneous Video-EEG monitoring facilitates precise classification of ictal versus postictal language alterations and differentiation of aphasic symptoms from speech automatisms.
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Affiliation(s)
- Iris Unterberger
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
| | - Eugen Trinka
- Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Gerhard Ransmayr
- Department of Neurology 2, Kepler University Hospital, Linz, Austria
| | | | - Gerhard Bauer
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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Lee JJ, Park JM, Kang K, Kwon O, Lee WW, Kim BK. Three Cases of Aphasic Status Epilepticus: Clinical and Electrographic Characteristics. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2021; 14:11795476211009241. [PMID: 33953631 PMCID: PMC8042546 DOI: 10.1177/11795476211009241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/20/2021] [Indexed: 11/23/2022]
Abstract
Aphasic status epilepticus (ASE) is unusual and has clinical characteristics similar to those of other disorders. Herein, we report 3 cases of ASE. A left-handed man (patient 1) showed continuous aphasia after the administration of flumazenil. He had underlying alcoholic liver cirrhosis and traumatic brain lesions in the right hemisphere. Electroencephalography (EEG) revealed periodic epileptiform discharges in the right frontotemporal area, which were intervened by rhythmic activity with spatiotemporal evolutions. A right-handed woman (patient 2) showed recurrent aphasia. Blood tests revealed a high blood glucose level (546 mg/dL) and high serum osmolality (309 mMol/L). Her EEG showed rhythmic activity in the left frontotemporal area with spatiotemporal evolutions on a normal background rhythm. She became seizure-free after the administration of an antiepileptic drug and strict glucose regulation. A right-handed woman (patient 3) developed subacute aphasia a week before hospital admission. She had a gradual decline of cognition 1 year before. Her EEG showed intermittent quasi-rhythmic fast activity in the frontotemporal area bilaterally, with fluctuating frequency and amplitude. The patient became seizure-free after the administration of an antiepileptic drug. Brain single-photon emission tomography performed after seizure control showed decreased perfusion in the left frontotemporal area. After discharge, her cognitive function gradually declined to a severe state of dementia. ASE can be caused by diverse etiologies; it is usually caused by cerebral lesions and less frequently by non-lesional etiologies or degenerative disorders. Adequate treatment of underlying disorders and seizures is critical for curing the symptoms of ASE.
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Affiliation(s)
- Jung-Ju Lee
- Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Jong-Moo Park
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University, Kyeongkido, Korea
| | - Kyusik Kang
- Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Ohyun Kwon
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University, Kyeongkido, Korea
| | - Woong-Woo Lee
- Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Byung-Kun Kim
- Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
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Azman F, Tezer FI, Saygi S. Aphasic status epilepticus in a tertiary referral center in Turkey: Clinical features, etiology, and outcome. Epilepsy Res 2020; 167:106479. [DOI: 10.1016/j.eplepsyres.2020.106479] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/24/2020] [Accepted: 09/27/2020] [Indexed: 10/23/2022]
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Nakayama Y, Nishibayashi H, Ozaki M, Yamoto T, Nakai Y, Nakao N. Aphasic status epilepticus of frontal origin treated by resective surgery. Epilepsy Behav Rep 2020; 14:100359. [PMID: 32435755 PMCID: PMC7229485 DOI: 10.1016/j.ebr.2020.100359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/11/2020] [Accepted: 02/12/2020] [Indexed: 11/13/2022] Open
Abstract
Aphasic status epilepticus (SE) is a clinical entity of SE, but it has not been well recognized. We report a 43-year-old female with a chronic drug-resistant epilepsy with aphasic SE, treated by resective surgery. The patient showed long-lasting weekly episodes of hypokinesia, slow verbal response, and dysphasia, which were diagnosed as symptoms of aphasic SE. Magnetic resonance imaging showed encephalomalacia in the left frontal lobe with a hemosiderin rim. Intracranial electroencephalography revealed continuous spikes, predominantly on the left superior frontal gyrus with hemosiderin deposit. The aphasic symptoms were seen when ictal discharges gradually spread to the wide area of the left anterior frontal lobe, including the language area. The episodes of recurrent aphasic SE had disappeared by one year after the left anterior frontal resection. We should consider aphasic SE when language impairment is episodic, and consider surgical intervention in cases where it repeatedly occurs despite appropriate medical therapy. Long-lasting slow verbal response and dysphasia could be manifestations of aphasic status epilepticus of frontal origin Epilepsy surgery should be considered for repeat aphasic SE under appropriate medical treatment after definite diagnosis Precise time correlations between aphasic symptoms and ictal discharges could be unclear even by intracranial electroencephalography.
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Dono F, Russo M, Carrarini C, Di Stefano V, Nanni S, Ferrante C, Onofrj M, Anzellotti F. Lateralized periodic discharges in insular status epilepticus: A case report of a periodic EEG pattern associated with ictal manifestation. Clin Neurophysiol Pract 2019; 4:27-29. [PMID: 30859143 PMCID: PMC6395825 DOI: 10.1016/j.cnp.2019.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/05/2019] [Accepted: 01/14/2019] [Indexed: 12/17/2022] Open
Abstract
Focal status epilepticus has to be considered in the differential diagnosis of patients presenting with aphasia, even in the absence of previous history of epilepsy. Aphasia can be a rare presenting sign of insular lobe epilepsy. Lateralized periodic discharges could represent an EEG ictal pattern.
Objective Insular lobe seizures generally represent a misconceived ictal phenomenon characterized by specific neurological signs. Aphasia can be a rare presenting sign associated with insular lobe epilepsy which could be easily mistaken for a manifestation of other acute brain diseases. Method We describe an insular status epilepticus (SE) characterized by sudden onset of language disturbance associated with hypersalivation and paraesthesia. A concomitant EEG recording showed the presence of Lateralized Periodic Discharges plus superimposed fast activity (LPDs + F). After an adequate acute endovenous anti-seizure treatment, a normalization of the EEG abnormalities with a complete resolution of all the neurological symptoms was achieved. Discussion Language disturbances can be usually found in various pathological acute pictures involving the dominant frontal and temporal lobes. The presence of certain EEG pattern, could rise the suspect of aphasia as a critical manifestation. LPDs pattern is usually correlated with structural lesions. The association between LPDs and seizure is controversial but it seems to be more consistent when they are associated with “Plus modifiers” and with an high periodic frequency. Conclusion Our case underlines the importance of considering focal SE in the differential diagnosis of patients presenting aphasia, even in the absence of previous history of epilepsy. We describe how LPDs can be associated with SE in a patient affected by a brain tumour, supporting the idea that some characteristic periodic patterns could be associated with seizure occurrence.
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Affiliation(s)
- Fedele Dono
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Italy
- Corresponding author at: Via dei Vestini 5, 66013 Chieti, Italy.
| | - Mirella Russo
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Italy
| | - Claudia Carrarini
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Italy
| | - Vincenzo Di Stefano
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Italy
| | - Stefania Nanni
- Department of Neurology, SS Annunziata Hospital, Chieti, Italy
| | - Camilla Ferrante
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Italy
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Requena M, Fonseca E, Olivé M, Abraira L, Quintana M, Mazuela G, Toledo M, Salas‐Puig X, Santamarina E. The ADAN scale: a proposed scale for pre‐hospital use to identify status epilepticus. Eur J Neurol 2019; 26:760-e55. [DOI: 10.1111/ene.13885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 12/06/2018] [Indexed: 12/20/2022]
Affiliation(s)
- M. Requena
- Epilepsy Unit Hospital Universitario Vall d'Hebron Barcelona Spain
| | - E. Fonseca
- Epilepsy Unit Hospital Universitario Vall d'Hebron Barcelona Spain
| | - M. Olivé
- Epilepsy Unit Hospital Universitario Vall d'Hebron Barcelona Spain
| | - L. Abraira
- Epilepsy Unit Hospital Universitario Vall d'Hebron Barcelona Spain
| | - M. Quintana
- Epilepsy Unit Hospital Universitario Vall d'Hebron Barcelona Spain
| | - G. Mazuela
- Epilepsy Unit Hospital Universitario Vall d'Hebron Barcelona Spain
| | - M. Toledo
- Epilepsy Unit Hospital Universitario Vall d'Hebron Barcelona Spain
| | - X. Salas‐Puig
- Epilepsy Unit Hospital Universitario Vall d'Hebron Barcelona Spain
| | - E. Santamarina
- Epilepsy Unit Hospital Universitario Vall d'Hebron Barcelona Spain
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Marques Mendes E, Mendes A, Ribeiro C, Guerra D. Adult-onset epileptic aphasia. BMJ Case Rep 2018; 2018:bcr-2018-225563. [PMID: 29960970 DOI: 10.1136/bcr-2018-225563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aphasia is a language disorder characterised by loss of ability to produce or comprehend written or spoken language. In majority of the cases, it is due to stroke. Aphasia may also present as an ictal or postictal state of temporal or frontal lobe seizures. Nevertheless, its isolated occurrence in individuals without a clear-cut history of seizures raises diagnostic difficulties with important therapeutic implications.A case of epileptic aphasia is reported in which the diagnosis was confirmed by electroencephalogram with a dramatic therapeutic response to an antiepileptic drug.
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Affiliation(s)
- Edite Marques Mendes
- Medicina 1, Unidade Local de Saude do Alto Minho EPE, Viana do Castelo, Portugal
| | - Amélia Mendes
- Neurology, Unidade Local de Saude do Alto Minho EPE, Viana do Castelo, Portugal
| | - Carlos Ribeiro
- Medicina 1, Unidade Local de Saude do Alto Minho EPE, Viana do Castelo, Portugal
| | - Diana Guerra
- Medicina 1, Unidade Local de Saude do Alto Minho EPE, Viana do Castelo, Portugal
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