[Ictal Speech Manifesting as Sleep Talking: A Case Report]

Area of Science:

• Neurology
• Epileptology
• Clinical Neuroscience

Background:

• Epilepsy diagnosis can be challenging, especially with atypical seizure presentations.
• Polymicrogyria, a cortical malformation, is associated with various neurological disorders, including epilepsy.
• Patient presented with a history of epilepsy and specific neurological findings on MRI.

Observation:

• A 28-year-old female with epilepsy since age 19 presented with right perisylvian polymicrogyria.
• Seizure symptoms included somatosensory aura, dyscognitive, and amnesic seizures.
• Patient's mother reported "sleep talking" episodes preceding epileptic seizures.

Findings:

• Long-term video electroencephalography (EEG) identified "sleep talking" as epileptic events.
• These events were characterized as ictal speech originating from the right hemisphere.
• The findings underscore the significance of "sleep talk" as a potential epileptic symptom.

Implications:

• "Sleep talking" should be considered a potential epileptic symptom in clinical practice.
• Thorough patient history is crucial for identifying pathological "sleep talk".
• Long-term video EEG is essential for accurate diagnosis and treatment of such cases.