Transient Broca's aphasia as feature of an extradural abscess.
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Diagnosis of extradural abscesses can be difficult and is often delayed. The case is presented of a 13-year-old girl who was afebrile and had episodes of expressive aphasia, with maintenance of awareness and understanding, lasting for 2-3 minutes and with normal neurologic examination in between. She was found to have a left frontal extradural abscess overlying the region of Broca's area (Brodmann area 44/45) on magnetic resonance imaging. An electroencephalogram showed continuous delta activity in the left frontotemporal region. She made a full recovery after surgical evacuation of pus, which upon culture grew Streptococcus milleri. The possible cause of transient aphasia in this condition is pressure-induced or inflammatory mediator-induced ischemia, with or without associated focal seizures.