Ictal paraphasia as an atypical manifestation of temporal lobe epilepsy.

Language disturbances are common manifestations of non-convulsive seizures in focal epilepsy. Ictal aphasia and speech arrest are the most representative. On the other hand, ictal paraphasia is a rare clinical manifestation of dominant temporal lobe epilepsy, with few cases reported in the literature. We describe a 73-year-old woman with focal onset unaware seizures presenting with phonemic paraphasias related to a left anterior temporal low-grade glioma. This ictal speech manifestation can be easily misdiagnosed and treated as other neurological or mental illnesses and can be considered a lateralizing sign in epilepsy when an appropriate anatomo - electro - clinical correlation is done.