A Case of Left Temporal Lobe Epilepsy with Transient Neologism

Abstract

측두엽뇌전증(temporal lobe epilepsy)은 가장 흔한 종류의 뇌전 증으로, 발작 초점에 따라 다양한 증상을 나타낸다. 발작 초점 의 편측화(lateralization)는 우성 반구가 초점인 경우 실어증, 비 우성 반구가 초점인 경우 구토, 기침 등의 증상으로 발작이 나타 날 수 있다. 이중 전신강직간대발작(generalized tonic-clonic seizure)이나 의식장애 없이 언어장애만 보이는 경우 측두엽뇌전증의 진단에 어려움이 있다. 이에 저자는 의식장애 없이 일시적인 신어조작증 (neologism)으로 발현한 좌측 측두엽뇌전증 증례를 경험하였기 에 이를 보고하자 한다. Temporal lobe epilepsy causes seizures, the semiology of which varies depending on lateralization, including aphasic seizures in the dominant hemisphere. Herein, the author report a rare case of isolated aphasia in a patient with left temporal lobe epilepsy. An 85-year-old man visited the emergency room, presenting with aphasia for 15 hours. He did not have any past medical history of neurologic diseases, but had diabetes and hypertension. Brain magnetic resonance imaging revealed no structural lesion capable of causing language dysfunction. The symptoms improved spontaneously after 1 day, but recurrent episodes of aphasia and neologism occurred. The author performed 24-hour video electroencephalography monitoring, which suggested aphasic seizures, and intermittent rhythmic delta activities were observed in the left temporal area. Therefore, the author initiated treatment with an antiseizure medication, and the patient was discharged without neurologic complications.