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[Acute language disorder in elderly patients: ischemic or epileptic origin?]
J L Sánchez1, M De Entrambasaguas, W J Schonewille
1Servicio de Neurología y Neurofisiología, Clínica Rotger, Palma de Mallorca, Spain. neuro@clinicarotger.es
Neurologia (Barcelona, Spain)
|December 18, 2001
Summary
Acute language disorders in elderly women, when accompanied by behavioral changes, may indicate temporal lobe seizures rather than cerebrovascular disease. These episodes resolved quickly, with EEG showing abnormalities but imaging revealing no acute lesions.
Area of Science:
- Neurology
- Neuroscience
- Epileptology
Background:
- Acute language disorders (aphasia) are typically associated with cerebrovascular events like stroke.
- However, atypical presentations in elderly patients warrant investigation into alternative etiologies, especially when behavioral disturbances are present.
Observation:
- Six elderly women (71-84 years) experienced mild behavioral changes followed by transient language impairments, including fluent dysphasia and comprehension difficulties.
- Symptoms resolved within 24 hours.
- Neuroimaging (MRI with diffusion-weighted imaging) showed no acute lesions.
Findings:
- Electroencephalography (EEG) revealed epileptogenic or slow waves in the temporal region during the acute phase in all patients.
- These EEG abnormalities normalized in follow-up recordings.
- No patient experienced recurrent episodes.
Implications:
- The findings suggest that acute language disorders with behavioral disturbance in the elderly may represent partial seizures originating from the temporal lobe.
- Electroencephalography is crucial for diagnosing these stroke mimics when neuroimaging is negative.
- This highlights the importance of considering non-vascular causes for transient neurological deficits in older adults.