Skip to main content
SpringerLink
Log in

When aphasia is due to aphasic status epilepticus: a diagnostic challenge

  • Brief Communication
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Aphasic status epilepticus is an uncommon entity that should be included in the differential diagnosis of persistent and sudden language disorders. In our study, we describe seven patients admitted with clinical and electroencephalographic diagnosis of aphasic status, who were studied with both neuroimaging and electroencephalogram. The mean age was 65.9 years (range of 39–89). Three of the patients had previously been diagnosed of epilepsy. The aphasia was global in six patients. In one case, we found foci of the left hemorrhagic contusions. The initial electroencephalogram (EEG) was not conclusive of status in two patients. In one patient, neuroimaging showed left hemispheric hypoperfusion, compatible with postictal changes. Six out of seven patients required at least two antiepileptic drugs. Three patients died of systemic complications (infectious causes), whereas the other four cases had a complete recovery. Our study highlights that a second EEG study might be necessary to confirm epileptiform activity, when clinical features and other tests suggest an epileptic origin. An early and specific treatment, avoiding or diminishing comorbidities, might significantly improve the prognosis of these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Rosenbaum DH, Siegel M, Barr WB, Rowan AJ (1986) Epileptic aphasia. Neurology 36(6):822–825. https://doi.org/10.1212/WNL.36.6.822

    Article  CAS  PubMed  Google Scholar 

  2. Ericson EJ, Gerard EE, Macken MP, Schuele SU (2011) Aphasic status epilepticus: electroclinical correlation. Epilepsia 52(8):1452–1458. https://doi.org/10.1111/j.1528-1167.2011.03084.x

    Article  PubMed  Google Scholar 

  3. Lv R-J, Wang Q, Cui T, Zhu F, Shao X-Q (2017) Status epilepticus-related etiology, incidence and mortality: a meta-analysis. Epilepsy Res 136:12–17. https://doi.org/10.1016/j.eplepsyres.2017.07.006

    Article  PubMed  Google Scholar 

  4. Benatar M (2002) Ictal aphasia. Epilepsy Behav 3(5):413–419. https://doi.org/10.1016/S1525-5050(02)00519-X

    Article  PubMed  Google Scholar 

  5. DeToledo JC, Minagar A, Lowe MR (2000) Persisting aphasia as the sole manifestation of partial status epilepticus. Clin Neurol Neurosurg 102(3):144–148. https://doi.org/10.1016/S0303-8467(00)00091-3

    Article  CAS  PubMed  Google Scholar 

  6. Hirsch LJ, Emerson RG, Pedley TA (2001) Prolonged “postictal” aphasia: demonstration of persistent ictal activity with intracranial electrodes. Neurology 56(1):134–136. https://doi.org/10.1212/WNL.56.1.134

    Article  CAS  PubMed  Google Scholar 

  7. Loesch AM, Steger H, Losher C, Hartl E, Rémi J, Vollmar C, Noachtar S (2017) Seizure-associated aphasia has good lateralizing but poor localizing significance. Epilepsia 58(9):1551–1555. https://doi.org/10.1111/epi.13835

    Article  CAS  PubMed  Google Scholar 

  8. Theitler J, Dassa D, Gandelman-Marton R (2017) The yield of non-elective inpatient video-EEG monitoring in adults. Neurol Sci 38(6):961–965. https://doi.org/10.1007/s10072-017-2872-2

    Article  PubMed  Google Scholar 

  9. Hirsch LJ, Gaspard N (2013) Status epilepticus. Continuum (Minneap Minn) 19(3 Epilepsy):767–794. https://doi.org/10.1212/01.CON.0000431395.16229.5a

    Google Scholar 

  10. Dong C, Sriram S, Delbeke D, Al-Kaylani M, Arain AM, Singh P, McLean MJ, Abou-Khalil B (2009) Aphasic or amnesic status epilepticus detected on PET but not EEG. Epilepsia 50(2):251–255. https://doi.org/10.1111/j.1528-1167.2008.01782.x

    Article  PubMed  Google Scholar 

  11. López Ruiz R, Quintas S, Largo P, de Toledo M, Carreras MT, Gago-Veiga A et al (2017) Usefulness of multiparametric computerized tomography findings in the differential diagnosis of stroke mimics of epileptic origin: a preliminary study. Neurologia:1–5. https://doi.org/10.1016/j.nrl.2016.10.010.

  12. Toledo M, Munuera J, Sueiras M, Rovira R, Alvarez-Sabín J, Rovira A (2008) MRI findings in aphasic status epilepticus. Epilepsia 49(8):1465–1469. https://doi.org/10.1111/j.1528-1167.2008.01620.x

    Article  PubMed  Google Scholar 

  13. Ferrari A, Renzetti P, Serrati C, Fancellu R (2017) Serial magnetic resonance study in super refractory status epilepticus: progressive involvement of striatum and pallidus is a possible predictive marker of negative outcome. Neurol Sci 38(8):1513–1516. https://doi.org/10.1007/s10072-017-3007-5

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Hospital Universitario de la Princesa, Calle Diego de León, 62, 28006, Madrid, Spain

    Sonia Quintas, Juan Camilo Ródriguez-Carrillo, María de Toledo & Ana Beatriz Gago-Veiga

  2. Epilepsy Unit, Department of Neurology, Hospital Ruber Internacional, Madrid, Spain

    Rafael Toledano

  3. Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain

    Francisco José Navacerrada Barrero

  4. Health Time, Córdoba, Spain

    M. Álvaro Berbís

Authors
  1. Sonia Quintas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juan Camilo Ródriguez-Carrillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rafael Toledano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. María de Toledo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Francisco José Navacerrada Barrero
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Álvaro Berbís
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ana Beatriz Gago-Veiga
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sonia Quintas.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical publication statement

We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Quintas, S., Ródriguez-Carrillo, J.C., Toledano, R. et al. When aphasia is due to aphasic status epilepticus: a diagnostic challenge. Neurol Sci 39, 757–760 (2018). https://doi.org/10.1007/s10072-017-3218-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-017-3218-9

Keywords

Search

Navigation