ICTAL SPEECH ARREST AND PARASAGITTAL LESIONS

Lesions in the parasagittal. region may cause seizures with speech arr est. To correlate lesion localization within the parasagittal region w ith ictal speech function we studied 11 patients with parasagittal les ions. The exact lesion localization was assessed with magnetic resonan ce imaging. In all patients with speech arrest the lesion involved the left superior frontal gyrus (n = 6), in 3 patients the lesion was con fined to this gyrus. Speech arrest did not occur in patients with righ t-sided lesions (n = 4) or left-sided lesions outside the superior fro ntal gyrus (n = 1). Our data suggest that a small lesion confined to t he left superior frontal gyrus (the supplementary motor area) is suffi cient to cause speech arrest.