Zaburzenia mowy po ataku padaczki w padaczce ogniskowej: perspektywa i spostrzeżenia logopedów
Post-Ictal aphasia in focal Epilepsy: Speech-language pathologist Perspectives and insights
W skrócie
Badacze przeanalizowali nagrania ataków padaczki u 77 pacjentów i odkryli, że u ponad 40% z nich pojawiały się czasowe zaburzenia mowy bezpośrednio po ataku, szczególnie gdy atak pochodził z płata skroniowego mózgu. Zaburzenia te były bardziej widoczne, gdy pacjenci przechodzili dokładne testy logopedyczne, co pokazuje, że dokładna ocena mowy po ataku jest ważna dla diagnostyki. Badanie potwierdziło, że rozszerzanie się elektrycznej aktywności padaczki na drugą stronę mózgu było najczęściej związane z występowaniem tych zaburzeń mowy.
Oryginalny abstract (angielski)
OBJECTIVE: To evaluate the prevalence and speech characteristics of post-ictal aphasia (P-IA) in people with epilepsy (PWE) undergoing long-term video-EEG (VEEG) monitoring (LTM). To investigate the relationship between anatomical and electroclinical data and specific post-ictal speech deficits. METHODS: A multidisciplinary team reviewed the medical records of PWE admitted to the Epilepsy Monitoring Unit between 2017-2020, selecting those who experienced at least one seizure during LTM and underwent postictal speech assessment. Clinical data were compared between patients with and without P-IA. In P-IA group, speech analysis was conducted by transcribing communicative interactions to identify specific language deficits and explore their associations with clinical data. RESULTS: From a pool of 114 PWE we included a total of 811 recorded events belonging to 77 patients. Adequate speech analysis was possible in 46 of these patients, and 20 of them exhibited P-IA. Patients with P-IA more frequently presented seizures with impaired awareness, a temporal lobe epileptogenic zone, ictal EEG patterns with contralateral diffusion and unilateral post-ictal focal slowing. With more thorough evaluation the detection rate rose from 26% in the overall cohort to 43.5%, reflecting improved diagnostic accuracy rather than a true increase in prevalence. CONCLUSION: The likelihood of detecting P-IA increases with comprehensive post-ictal language testing. P-IA in current study showed no clear lateralizing value. The contralateral spread of seizure was the most relevant finding correlated with P-IA. More than four post-ictal language deficits were correlated with onset in the temporal lobe.