Automatisms with preserved responsiveness and ictal aphasia: Contradictory lateralising signs during a dominant temporal lobe seizure

J. Janszky, A. Balogh, A. Holló, A. Szucs, C. Borbély, P. Barsi, J. Vajda, P. Halász

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The 25-year-old right-handed woman suffering from temporal lobe epilepsy (TLE) was referred to our centre for presurgical evaluation. MRI showed a right-sided hippocampal sclerosis. During video-EEG-recorded seizures, abdominal aura was followed by oral automatisms, during which she was completely reactive to external stimuli, although she was unable to speak. Ictal EEG showed right temporal seizure pattern, without contralateral propagation. She had abnormal speech postictally. Speech-activated functional transcranial Doppler sonography revealed right-sided speech dominance. She has become seizure free after a right-sided amygdalo-hippocampectomy. In our patient, contradictory clinical ictal lateralising signs (automatisms with preserved responsiveness vs. ictal and postictal dysphasia) occurred during right-, speech-dominant-sided seizures. This is the first report when automatisms with preserved consciousness occurred during a seizure originating and involving the speech-dominant hemisphere.

Original languageEnglish
Pages (from-to)182-185
Number of pages4
JournalSeizure
Volume12
Issue number3
DOIs
Publication statusPublished - Apr 2003

Keywords

  • Brain lateralisation
  • Consciousness
  • Epilepsy surgery
  • Ictal automatism
  • Speech disturbance
  • Temporal lobe epilepsy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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