Thread by @MedinaRiojaMD

Seizure semiology and localization: not everything is generalized onset tonic-clonic. 🧠⛈️

Part 3: language features🗣️

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#Neurology #neurotwitter #Teaching #Education #EndNeurophobia

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Intro
The following symptoms are frequently seen in focal epilepsies.

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🚨
This tweetorial is based on:
Epilepsy Behav. 2005 Aug;7(1):1-17.
doi: 10.1016/j.yebeh.2005.04.004
This paper was written using the previous classification system and some data may need an update, nevertheless I find it useful when teaching about seizure semiology. 📓

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1⃣ Ictal aphasia

Sx: motor/receptive aphasia.

Where? Inferior frontal gyrus (Broca), the supramarginal and superior temporal gyrus (Wernicke), and the basal temporal area. Dominant hemisphere.

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1⃣ Ictal aphasia

#CuriousFact more than a single area, some authors propose the term "Broca's system/complex" to describe the relationship between some zones in the cortex involved in language production.

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2⃣ Ictal vocalizations

Sx: sound not being of speech quality and not accompanying apnea.🔊

Where? Dominant frontal lobe.

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3⃣ Ictal speech

Sx: intelligible speech during the period of seizure.

Where? Nondominant hemisphere.

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Only part 4 is missing (post ictal features).
Wait for it...🧠⛈️

Sources:
1.- Epilepsy Behav. 2005 Aug;7(1):1-17.
doi: 10.1016/j.yebeh.2005.04.004
2.- Epilepsia. 2017 Apr;58(4):522-530.
doi: 10.1111/epi.13670
3.- Front Hum Neurosci. 2016 Jun 1;10:249.
doi: 10.3389/fnhum.2016.00249

Sources:
4.- J Epilepsy Res. 2014 Dec 31;4(2):78-81.
doi: 10.14581/jer.14016
5.- Seizure. 2018 Aug;60:178-183.
doi: 10.1016/j.seizure.2018.07.008.