Ictal Forced Repetitive Swearing in Frontal Lobe Epilepsy: Case report and review of the literature
Published Online: Nov 14, 2014
Page range: 113 - 119
Received: Oct 27, 2014
Accepted: Nov 05, 2014
DOI: https://doi.org/10.21307/joepi-2015-0019
Keywords
© 2014 Marjan Dolatshahi et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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.