Aphasic status epilepticus as the sole symptom of epilepsy: A case report and literature review

Abstract

Aphasia is a common symptom encountered by neurologists. However, the presence of aphasia as the sole manifestation of partial status epilepticus is rare. The present study reports a case of aphasic status epilepticus in a 27-year-old right-handed female who presented after the abrupt onset of aphasia, which had persisted for 1.5 days. The patient's medical history included head trauma followed by a craniectomy and cranioplasty. Computed tomography scans revealed a lesion in the patient's left parietal lobe, and an electroencephalogram showed a spike and slow wave pattern in the left hemisphere of the brain during aphasia. The patient's condition improved after the oral administration of oxcarbazepine daily. In the present study it was observed that EEGs were a simple method to diagnose aphasic seizures and therefore EEG recordings should be performed in all cases of unexplained aphasia. In addition, the present study reviewed previously reported cases of aphasic status epilepticus.

Keywords: EEG; aphasia status epilepticus; epilepsy.

Figure 1.

Computed tomography scans performed on the 27-year-old female patient upon admission, which revealed a lesion on the left parietal lobe. Four different slices of the cerebral lesion are shown. The arrow indicates the lesion.

Figure 2.

EEGs of the seizure ictal performed on the 27-year-old female patient upon the admission. The EEG revealed irregular spikes and slow wave delta activity in the left central and temporal regions, leading to a diagnosis of Broca's aphasia. EEG recorded the change of wave during the ictal phase. EEG, electroencephalogram.

Figure 3.

Electroencephalogram performed after the administration of antiepileptic treatment demonstrated the reversal of the aphasic disorder.