ICTAL SPEECH MANIFESTATIONS IN TEMPORAL-LOBE EPILEPSY - A VIDEO-EEG STUDY

To evaluate ictal speech manifestations in complex partial seizures (C PS), we reviewed videotapes of 68 consecutive patients who underwent a nterior temporal lobectomy (ATL) for treatment of intractable epilepsy in Taiwan. In all, 261 CPS were collected from their video-EEG (VEEG) recordings. Cerebral speech dominance was determined by intracarotid injection of sodium amobarbital (Wada test) in all cases. Ictal speech manifestations, classified as verbalization or vocalization, occurred in 32 patients (47.1%) with 96 seizures (36.8%). Ictal verbalization occurred in 10 patients (14.7%). Ictal vocalization was observed in 28 patients (41.2%); including 6 patients who also had ictal verbalizati on. Thirty-six patients (52.9%) had no seizure with ictal speech manif estations. Ictal verbalization had significant lateralization value: 9 0% of patients with this manifestation had seizure focus in the nondom inant temporal lobe (p 0.049). Seizures of patients with ictal vocaliz ation were not more likely to arise from either temporal lobe. We also observed bilingual patients who exclusively spoke in their mother ton gue (Taiwanese) rather than the acquired language (Mandarin) in 72.2% of seizures with verbalization. This finding is significant and contra ry to a commonly held notion that the acquired language is used in sei zures associated with speech behaviors. manifestations-vocalization-ve rbalization.