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Citation Information : Journal of Epileptology. VOLUME 22 , ISSUE 2 , ISSN (Online) 2300-0147, DOI: 10.1515/joepi-2015-0019, December 2014
License : (CC BY 4.0)
Received Date : 27-August-2014 / Accepted: 05-November-2014 / Published Online: 14-November-2014
Introduction. Dominant presentation of ictal forced repetitive swearing has been rarely addressed and could be misdiagnosed.
Case report. We report a 45-year-old man with a long history of right frontal lobe epilepsy (FLE) who developed forced repetitive swearing during hypermotor seizures. His seizures were refractory to different antiepileptic drugs (AEDs). Scalp video-EEG telemetry suggested a right frontal epileptic focus. Magnetic resonance imaging (MRI) suggested focal cortical dysplasia (FCD) in the right mesial frontal lobe. Intracranial implantation with video-EEG recordings confirmed seizures originating from the MRI lesion. Patient underwent right frontal lobe resection followed by seizure freedom in the last five years on a single AED. Neuropathology confirmed FCD type IIB.
Discussion. The following aspects of the case are discussed: FLE and ictal vocalization, swearing, FLE and aggression. We emphasize the differences among ictal vocalisation, verbal automatism and ictal speech. We propose that ictal swearing might fit a verbal automatism definition.
Conclusion. Ictal forced repetitive swearing can be a manifestation of hypermotor seizures in FLE and should not be misdiagnosed.
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