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Symptomatic epilepsy with facial myoclonus triggered by language
M P Canevini1, A Vignoli, V Sgro
1Centro Regionale Epilessia, A.O. San Paolo, Via A. di Rudinì, 8, 20142 Milan, Italy. crehsp@mailserver.unimi.it
Epileptic Disorders : International Epilepsy Journal with Videotape
|October 27, 2001
Summary
A patient developed stuttering and facial myoclonic jerks due to a left frontal lesion sustained 50 years prior. These symptoms were triggered by speech and language processing, correlating with EEG abnormalities.
Area of Science:
- Neuroscience
- Neurology
- Epileptology
Background:
- A left frontal lobe lesion, sustained decades earlier, can manifest with delayed neurological symptoms.
- Late-onset neurological disorders present unique diagnostic challenges.
Observation:
- A 57-year-old patient presented with non-fluent aphasia and facial myoclonic jerks.
- Symptoms were triggered by reading, speaking, and listening to spoken language, causing stuttering.
- Video-polygraphic EEG revealed left fronto-temporal spikes and polyspikes correlating with myoclonic jerks.
Findings:
- Facial myoclonus was the sole seizure manifestation.
- Both seizures and language impairment exhibited a very late onset, approximately 50 years post-injury.
- The patient's stuttering was clinically determined by submental myoclonic jerks.
Implications:
- This case highlights the potential for long-term, delayed-onset neurological sequelae from traumatic brain injury.
- It underscores the link between focal epilepsy, specifically facial myoclonus, and acquired stuttering.
- Understanding such late-onset presentations is crucial for accurate diagnosis and management in neurology and neuropsychology.