Language-induced seizure. A case of cortical origin

After anastomosis of the superficial temporal to the middle cerebral artery, partial motor seizures referable to the left inferior motor strip and Broca's area developed in a 48-year-old man. These seizures were readily induced by attempts to speak, to read silently or aloud, and to write. The seizures were not induced by simple movements of the ocular, facial, jaw, throat, and extremity muscles, primary sensory stimuli, or higher intellectual function such as calculation. The patient had nonfluent dysphasia, but he had no comprehension disorder. A clear focal onset of electrographic seizures was recorded maximally at the left temporal region on reading aloud and at the left central area on writing. The cerebral evoked potentials were mildly abnormal on the affected hemisphere. This case shows cortical onset of language-induced seizure.