Ictal dysprosody and the role of the non-dominant frontal operculum

Prosody is an important feature of language and refers to variations in the acoustic properties of timing, intensity and fundamental frequency that are used to convey affective or linguistic information. The prosodic component of ictal speech has not yet been specifically studied in epileptic patients. We report the case of a patient with right mesial temporal lobe epilepsy who developed ictal, recurrent speech utterances associated with an altered prosody during both spontaneous seizures and a very localized stimulation-induced discharge of the non-dominant precentral operculum, a finding consistent with results of functional magnetic resonance imaging studies in healthy subjects. This should prompt future studies, with the aim of better evaluating the localizing value of ictal dysprosody in patients with drug resistant, partial epilepsy.