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Non-convulsive status epilepticus presenting with Wernicke's aphasia.
Mashael Al-Qahtani1, Sonia A Khan, Mohammed Kabiraj
1Division of Neurology, Department of Clinical Neurosciences, Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia.
Neurosciences (Riyadh, Saudi Arabia)
|November 5, 2010
Summary
This study details a rare case of non-convulsive partial status epilepticus presenting as Wernicke
Area of Science:
- Neurology
- Epileptology
- Neuroscience
Background:
- Ictal aphasia, particularly fluent (Wernicke's) aphasia, is an uncommon manifestation of seizures in adults.
- Previous literature predominantly reports non-fluent (Broca's) aphasia during ictal events.
Purpose of the Study:
- To report a unique case of recurrent non-convulsive partial status epilepticus presenting as fluent (Wernicke's) aphasia.
- To highlight the diagnostic challenges and successful management of this rare neurological condition.
Main Methods:
- Case report of a 47-year-old woman with recurrent episodes of Wernicke's aphasia.
- Diagnostic workup included Magnetic Resonance Imaging (MRI) of the brain and scalp Electroencephalography (EEG).
- Treatment involved intravenous diazepam and loading doses of phenytoin and phenobarbitone for status epilepticus.
Main Results:
- The patient presented with a 2-week history of Wernicke's aphasia episodes.
- EEG confirmed continuous periodic sharp waves in the left temporal regions, indicative of seizure activity.
- Clinical and EEG improvements were observed following anticonvulsant therapy, with resolution of ictal rhythms.
Conclusions:
- Non-convulsive partial status epilepticus can manifest as ictal fluent aphasia (Wernicke's type).
- Prompt diagnosis and management with anticonvulsant medications are crucial for clinical recovery.
- This case expands the understanding of diverse seizure presentations in adults.
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