내측 측두엽 간질에서 간질발작 중 언어 증상

Abstract

Background and Objectives : Several speech manifestation are observed in temporal lobe epilepsy(TLE). We studied the frequency of ictal speech manifestations and their localizing and lateralizing value in TLE. Methods : We reviewed 379 seizures recorded on videotape in 135 patients who underwent temporal lobectomy for intractable TLE. We divided patients into group A(n=75) who became seizures free after surgery, and group B(n=60) who were only slightly benefited or unchanged after surgery. Speech manifestations were classified as normal speech, vocalization, or abnormal speech. Abnormal speech was subdivided into speech arrest, dysarthria, dysphasia, or nonidentifiable speech. Results : Speech manifestations occurred in 70(18.5%) seizures of 28 patients. Forty eight seizures of 20 patients were observed in group A, and 22 seizures of 8 patients were observed in group B. In group A, 25 seizures of 11 patients were originating from dominant hemisphere, 23 seizures of 9 patients from nondominant hemisphere. In group B, 13 seizures of 5 patients were originating from dominant hemisphere, and 9 seizures in Lt. side and 6 seizures in Rt. side, respectively) of group A(P＞0.05), and eleven seizures of 4 patients(8 seizures from Lt. side and 3 seizure from Rt. side) in group B(P＞0.05). Normal speech was observed only seizures from Rt. side in both groups(3 seizures in 1 patient, each group). Dysphasia occurred only in seizures originating from Lt. side. Nonidentifiable speech occurred in 22 seizures of 9 patients(11 seizures from each side) in group A(P＜0.01), and 3 seizures of 1 patient occurred only from Lt. side in group B. Conclusion : Ictal speech manifestations were not uncommon(18.5%). All kinds of ictal speech manifestations except normal speech have no reliable lateralizing and localizing value in TLE. Normal speech could be a good indicator of seizure originating from nondominant hemisphere.