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  • Updated 10.02.2023
  • Released 08.02.2010
  • Expires For CME 10.02.2026

Aphasic seizures



This article describes the basics of aphasic seizures. An aphasic seizure is an inhibitory form of epileptic seizure that disrupts cognitive tasks involving language. Transient ischemic attacks or stroke could be first evoked by clinicians not aware of this possibility. Careful examination, medical history, and EEG should help the neurologist in making the correct diagnosis and introducing adequate therapeutics. Aphasia can occur in patients with epilepsy with auditory features and other epilepsies with seizures arising from or spreading to the dominant lateral temporal neocortex.

Key points

• Aphasic seizure is a specific type of inhibitory seizure.

• Aphasic status epilepticus should be considered in patients with transient and sustained aphasia not better explained by acute acquired brain lesion (stroke).

• EEG and brain imaging (including functional brain imaging) could help differentiate an aphasic seizure from aphasia due to other causes.

Historical note and terminology

Although the functional anatomy of speech processing has been investigated intensively for almost 150 years, the neural organization of speech perception remains highly debated, even in gross anatomical terms (27). Aphasia could be defined as language impairment caused by a permanent or transient injury to the brain, in a previously normal language user. The deficit may range from very limited problems in exact word finding to more pervasive deficits impacting on all language modalities. Speech production, verbal comprehension, word finding, and repetition can be affected to varying degrees, with or without reading and writing abnormalities.

In most left-handed people and almost all right-handers, left hemispheric dysfunction is responsible for language disorders. However, right hemisphere lesions or transient impairment could produce some language problems such as dysprosody. After Paul Brocas description of the loss of articulate speech following ischemic damage located in the posterior inferior frontal gyrus of the left hemisphere, several other aphasia syndromes have been described, including anomic aphasia, global aphasia, transcortical motor aphasia, Wernicke aphasia, conduction aphasia, and transcortical sensory aphasia. Each aphasic syndrome is presumed to be associated with specific brain area damage, although this remains controversial, even with respect to very ancient observations, as in Broca aphasia (24).

As already mentioned on what should be considered as a true aphasic seizure, there are numerous potential causes for a patients inability to speak, and thus, aphasia is not synonymous with not speaking. A comatose patient or a patient refusing to communicate with doctors or caregivers is not aphasic. Evidence of inappropriate use of language should be collected by examiners to document the diagnosis of aphasia: inability to correctly name objects or point to objects named by others, incorrect comprehension or repetition of sentences, words, and non-words, disturbed syntax or grammar, paraphasic errors, etc.

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