JLE

Epileptic Disorders

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Let's all repeat – palilalia may be epileptic! Volume 24, issue 1, February 2022

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  • Let’s all repeat – palilalia may be epileptic!
  • Let’s all repeat – palilalia may be epileptic!

We report a 42-year-old right-handed man with drug-resistant focal epilepsy due to viral encephalitis who was referred to our center for new-onset spells characterized by rapid breathing and repetition of syllables. On video-scalp EEG evaluation (video sequence 1), these spells of hyperventilation and palilalia were captured with EEG correlate of a bilateral temporal seizure. Subsequent stereo-EEG evaluation showed independent left and right hippocampal seizures; hyperventilation and palilalia were seen upon right frontal lobe recruitment (video sequence 2). Palilalia consists of a speech perseveration wherein patients compulsively repeat syllables, words, or phrases. It has been associated with multiple psychiatric and neurologic disorders including stroke, degenerative disorders, tic syndromes, and – rarely – epilepsy [1, 2]. Epileptic palilalia seems to be a manifestation of frontal involvement [2, 3] either primarily or secondarily due to spread from hippocampal seizures from either hemisphere. Additionally, echolalia-palilalia has also been associated with non-convulsive status epilepticus for which the EEG shows generalized discharges with occasional left frontal predominance [4].

Supplementary material

Summary slides accompanying the manuscript are available at www.epilepticdisorders.com.

Disclosures

F. Nascimento is a member of the Epileptic Disorders Editorial Board. J. Gavvala reports no disclosures relevant to the manuscript.