Case of epilepsy with speech disorders: EEG changes and magnetoencephalographic analysis

Abstract

We report a 6-year-old girl who developed speech and oromotor deficits during the course of epilepsy. Before the onset of the speech disorders, EEG showed spikes over the bilateral frontotemporal region (predominantly on the left side) and occasionally over the bilateral central region. At the onset of the speech disorders, EEG showed background activity mixed with high-voltage slow waves over diffuse regions, predominantly over the left side, and multifocal spikes and slow spike and wave (SW) complexes. Magnetoencephalography (MEG) showed three dimensionally that the calculated foci of temporal spikes were especially located beneath the somatosensory area for the right thumb. The focal EEG abnormalities over the left temporal region and the abnormal background activity were considered to have become serious and to have caused the speech and oromotor deficits. Antiepileptic drug (AED) therapy led to marked improvement of EEG, and oral corticosteroid administration had a beneficial effect on the speech disorders. Some investigators believe that benign childhood epilepsy with centrotemporal spikes (BECTS) and acquired epileptic aphasia represent a spectrum. Our patient had some of the clinical manifestations and EEG findings of these two epileptic syndromes. Therefore, we suggest that the condition of our patient lies between these two syndromes