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Postictal mixed transcortical aphasia.

Abstract
Postictal aphasia has been described in left temporal lobe seizures. It may be of fluent, non-fluent or global type. We present here a patient who displayed signs of mixed transcortical aphasia (MTCA). The patient was a 67 year old man who underwent excision of a left frontal parasagittal meningioma in 1987. Since then he has been treated with phenytoin for generalized tonic-clonic seizures (GTCS). He was admitted in status epilepticus. On awakening, the patient was non-fluent with palilalia and echolalia. His repetition was relatively preserved but all the other language functions were impaired. This picture faded away within a few hours. Brain CT, performed during this postictal state, was normal except for signs related to frontal craniotomy. SPECT, which was performed after language functions returned to normal, displayed left frontal, cingular and insular hypoperfusion. The postictal language dysfunction of the patient corresponded to MTCA. Although our case has frontal, he had no other structural lesion that could explain either diffuse ischemia of the left hemisphere or watershed areas secondary to the generalized seizures. The uniqueness of this case is the combination of postictal MTCA with good prognosis.
AuthorsA E Yankovsky, T A Treves
JournalSeizure (Seizure) Vol. 11 Issue 4 Pg. 278-9 (Jun 2002) ISSN: 1059-1311 [Print] England
PMID12027578 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright 2002 BEA Trading Ltd. Published by Elsevier Science Ltd. All rights reserved.
Chemical References
  • Anticonvulsants
  • Phenytoin
Topics
  • Aged
  • Anticonvulsants (therapeutic use)
  • Aphasia (etiology, physiopathology)
  • Aphasia, Broca (etiology, physiopathology)
  • Cerebrovascular Circulation (physiology)
  • Electroencephalography
  • Epilepsy, Temporal Lobe (complications, diagnosis, drug therapy)
  • Epilepsy, Tonic-Clonic (complications, diagnosis, drug therapy)
  • Frontal Lobe (blood supply, diagnostic imaging, physiopathology)
  • Humans
  • Male
  • Phenytoin (therapeutic use)
  • Tomography, Emission-Computed, Single-Photon
  • Tomography, X-Ray Computed

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