Referring to the article by Sakata et al. we disagree with the diagnosis “thalamic
aphasia” [
[1]
]. Since thalamic lesions can be associated with status epilepticus (SE) [
[2]
], it is crucial that SE has been ruled out
2Abbreviations CK: creatine-kinase; EEG: electroencephalography; FLAIR: fluid attenuated inversion
recovery; PLEDS: periodic lateralised epileptiform discharges; PWI: perfusion-wieghted
imaging; SE: status epilepticus; SLE: stroke-like episode; SLL: stroke-like lesion.
. Therefore, we should know if creatine-kinase (CK) was elevated to 5883 U/l due to
myopathy, the stroke-like lesion (SLL), cardiomyopathy, or a SE. Because periodic
lateralised epileptiform discharges (PLEDs) can be the manifestation of a non-convulsive/minimal
convulsive SE [
[3]
], we should know if a SE was recorded on electroencephalography (EEG) on hospital-day
8 and why midazolam was administered. Since headaches were interpreted as epileptogenic,
we should know whether the patient had seizures or epileptiform discharges on EEG.
A structural lesion is not a prerequisite for amnestic aphasia since SE may explain
aphasia. It could be also a post-ictal phenomenon. Was a third EEG free of epileptiform
discharges? Was the patient discharged with an anti-seizure medication?Keywords
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References
- Thalamic aphasia associated with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes: a case report.Brain Dev. 2022; 44: 583-587
- Non-convulsive status epilepticus induced by acute thalamic lesions: a report of three cases.Seizure. 2021; 89: 1-4
- Non-convulsive status epileptics presenting with periodic lateralized epileptiform discharges and coma after cerebral hemorrhage: a case report.Neurol India. 2021; 69: 733-736
- Metabolic stroke or stroke-like lesion: peculiarities of a phenomenon.J Neurol Sci. 2020; 412: 116726
Article Info
Publication History
Published online: June 14, 2022
Accepted:
May 29,
2022
Received:
May 18,
2022
Identification
Copyright
© 2022 The Japanese Society of Child Neurology Published by Elsevier B.V.
