Abstracts

Language-induced epilepsy includes seizures precipitation by speaking, reading, and writing. The seizures are similar to those of primary reading epilepsy, and patients may report one or several seizure triggers related to language. The nosologic position of language-induced epilepsy is not clear: reported cases resemble reading epilepsy but are more heterogeneous than those of primary reading epilepsy. We have had the opportunity to better characterized this syndrome, we performed a clinical and neuro-physiological study in a multigenerational family. Fifteen members (8 affected) on 3 generations were studied. All patients underwent an EEG-Video (awake and during sleep). A standardized protocol was applied in order to test the effect of reading, speech, praxis during EEG-Video monitoring. We found three cases of idiopathic generalized epilepsy (IGE). Five patients presented jaw jerking induced by language mimicking stuttering and corresponding to focal myoclonias involving oro-facial muscles. We found rolandic EEG spikes, inter-ictal when spike were followed by a slow wave, symptomatic of facial myoclonias if isolated. CT scan or MRI when performed were normal. Levetiracetam was effective in four patients. This family study demonstrates phenotypic heterogeneity. Patients may present isolated facial myoclonias induced by speech without generalized tonico-clonic seizures. Epileptic origin of stuttering may be investigated when familial history is positive for IGE. A common genetic base is under investigation.