Ictal Coprolalia: A Case Report and Review of Ictal Speech as a Localizing Feature in Epilepsy

BACKGROUND: Recognizing ictal semiology is an essential component to localization of seizure onset, especially in intractable epilepsy where surgical therapies may be beneficial. Ictal speech can be a common component of seizure semiology, but the various forms of ictal speech may have different lateralizing and localizing value. Coprolalia is a very rare form of ictal speech. METHODS: We present a 15 year old with medically intractable seizures characterized by agitation and coprolalia. RESULTS: The patient underwent surgical evaluation including video EEG, MRI, and functional neuroimaging. These studies indicated onset within the dominant frontal lobe which was further localized using stereo-electroencephalography prior to focal cortical resection. CONCLUSIONS: Ictal coprolalia is a rare presentation of ictal speech. We review the various forms of ictal speech and their value in localizing seizure onset. (C) 2016 Elsevier Inc. All rights reserved.