A CHANCE SPECT STUDY OF ICTAL APHASIA DURING SIMPLE PARTIAL SEIZURES

We report obtaining an ictal single photon emission computed tomograph ic (SPECT) scan in a right-handed 51-year-old man who had an astrocyto ma in the left cerebral hemisphere and simple partial seizures charact erized by aphasia. An epileptic seizure producing loss of speech and r ight-sided facial twitching occurred by chance during a SPECT scan. Du ring the attack, he was unable to speak, but auditory comprehension an d writing were intact. Ictal SPECT showed an area of increased perfusi on in the left frontal cortex, with the area of highest perfusion invo lving the left frontal operculum to the inferior part of the left prec entral gyrus. Interictal SPECT showed hypoperfusion in the same area. These SPECT findings suggest that the frontal operculum of the dominan t hemisphere is one of the regions that can give rise to epileptic aph asia.