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  1. 1 Journal of Epileptology

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  1. 1 2014

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  1. 1 Dolatshahi M.

  2. 1 Yankovsky A.

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Ictal Forced Repetitive Swearing in Frontal Lobe Epilepsy: Case report and review of the literature

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Dolatshahi M., Yankovsky A.
Journal of Epileptology
|
2014
|
vol. 22
|
issue 2
113-119
EN
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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