A Chance SPECT Study of Ictal Aphasia During Simple Partial Seizures

• Published in: Epilepsia (Copenhagen) Vol. 38; no. 3; pp. 374 - 376
• Main Authors: Sakai, Keiko, Hidari, Mitsuharu, Fukai, Mitsuhiro, Okamura, Takehiko, Asaba, Hiroyuki, Sakai, Toshiaki
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-03-1997; Blackwell
• Subjects: Aphasia; Astrocytoma; Astrocytoma - complications; Astrocytoma - diagnosis; Biological and medical sciences; Brain Neoplasms - complications; Brain Neoplasms - diagnosis; Cerebrovascular Circulation; Electroencephalography; Epilepsies, Partial - diagnosis; Epilepsies, Partial - diagnostic imaging; Frontal Lobe - diagnostic imaging; Frontal Lobe - physiopathology; Frontal operculum; Functional Laterality; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Landau-Kleffner Syndrome - diagnosis; Landau-Kleffner Syndrome - diagnostic imaging; Landau-Kleffner Syndrome - etiology; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Organotechnetium Compounds; Oximes; Simple partial seizures; Single photon emission computed tomography; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Human; Nervous system diseases; Frontal lobe; Left; Radiodiagnosis; Epilepsy; Exploration; Male; Operculum; Photon; Language disorder; Cerebral disorder; Crisis; Case study; Glioma; Partial; Cerebral hemisphere; Central nervous system disease; Aphasia; Medical imagery; Tumor; Computerized axial tomography; Neurological disorder; Astrocytoma
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1111/j.1528-1157.1997.tb01131.x

We report obtaining an ictal single photon emission computed tomographic (SPECT) scan in a right‐handed 51‐year‐old man who had an astrocytoma in the left cerebral hemisphere and simple partial seizures characterized by aphasia. An epileptic seizure producing loss of speech and right‐sided facial twitching occurred by chance during a SPECT scan. During the attack, he was unable to speak, but auditory comprehension and writing were intact. Ictal SPECT showed an area of increased perfusion in the left frontal cortex, with the area of highest perfusion involving the left frontal operculum to the inferior part of the left precentral gyrus. Interictal SPECT showed hypoperfusion in the same area. These SPECT findings suggest that the frontal operculum of the dominant hemisphere is one of the regions that can give rise to epileptic aphasia.