Abstract
A prolonged dysphasic seizure was recorded using chronic intracranial EEG ⁄ CCTV in a 30 year old right-handed patient with temporal lobe epilepsy, who was a candidate for surgery because of intractable seizures. The spike discharges began in the right temporal lobe, spread then through left occipital lobe into left temporal lobe, without involving frontal and mesial temporal structures. The right temporal lobe discharges elicited no clinical manifestations. When the discharges spread to the left temporal lobe, the patient uttered an irrelevant context (speech automatism) followed by mutism and neologism. While the right temporal lobe discharges disappeared but the left temporal lobe discharges were persisting, anomia and comprehension disturbance were the prominent features. After 14 min. 20 sec. all the spike discharges disappeared to result in a gradual recovery of speech.
This rare condition demonstrated that the different dysphasic symptoms could correspond to the ictal discharges in different localization.
