Abstracts

Rationale: A variety of speech automatisms have been described. Ictal swearing has not been well characterized and may provide clinical information and insight into the mechanisms of stereotyped ictal behavior. Methods: Retrospective chart and video analysis of 8 patients featuring ictal swearing. Seizure localization was determined based on clinical (8/8), structural (7/8) and electrophysiological (8/8 scalp EEG; 4/8 intracranial EEG) data. Results: All patients were male and right-handed except one (still with left-hemisphere dominance determined by amobarbital test). Ictal swearing occurred inconsistently during seizures and generally co-existed by other verbal or motor automatisms. All had right-sided seizures confirmed by video-EEG but focus localization was varied: orbitofrontal (1), inferior frontal gyrus (2), mesiotemporal (3), mesioparietal (1) and mesio-occipital (1). Conclusions: Ictal swearing is more commonly seen in male subjects, lateralizes to the non-dominant hemisphere but has poor localization value.