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Aphasia Owing to Subcortical Brain Infarcts in Childhood

Service de Neurolgie Département de Pédiatrie, CHU Bicêtre, Paris, France

Nathalie Seibel

Service de Neurolgie Département de Pédiatrie, CHU Bicêtre, Paris, France

Constance Rouvière, BA

Service de Neurolgie Département de Pédiatrie, CHU Bicêtre, Paris, France

Béatrice Husson, BA

Service de Radiologie Département de Pédiatrie, CHU Bicêtre, Paris, France

Brigitte Hermans, MD

Unité de Neurologie du Développement Université Catholique de Louvain, Brussels, Belgium

Nicole Laporte, MD

Unité de Neurologie du Développement Université Catholique de Louvain, Brussels, Belgium

Hazim Kadhim, MD, PhD

Unité de Neurologie du Développement Université Catholique de Louvain, Brussels, Belgium, Unité de Neuropathologie, Service d'Anatomopathologie, CHU Brugmann-HUDERF, Université Libre de Bruxelles, Brussels, Belgium

Cécile Grandin, MD

Service de Neuroradiologie, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium

Pierre Landrieu, MD

Service de Neurolgie Département de Pédiatrie, CHU Bicêtre, Paris, France

Guillaume Sébire, MD

Service de Neurolgie Département de Pédiatrie, CHU Bicêtre, Paris, France, Guillaume.Sebire{at}Usherbrooke.ca, Unité de Neurologie du Développement Université Catholique de Louvain, Brussels, Belgium, Service de Neurologie, Département de Pédiatrie, Université de Sherbrooke, Sherbrooke, QC, Canada

The aim of this study was to further define the clinical features of subcortical aphasia in children with deep brain infarcts and to define the sequelae associated with childhood strokes. We retrospectively studied nine children with left subcortical brain infarcts who presented with acquired language disorder and underwent language investigations based on standardized tests. Stroke in these patients involved the left internal capsule, lenticular or thalamic nuclei, or a combination of these. Early aphasic manifestations following the deep cerebral infarcts affected language expression. These included mutism, nonfluent speech, word finding difficulties, and phonemic and semantic paraphasia. Speech comprehension was generally more preserved. All patients subsequently improved, although variably; sequelae such as dysfluency, word finding difficulties, and written language learning impairment could be detected through standardized tests in six of them (all younger than 6 years at the time of the infarct). Two of the three remaining patients (both older than 6 years at the time of the infarct) had a full recovery. Our study confirms the concept of childhood subcortical aphasia, depicts the linguistic profile in these patients, and sustains the indication of systematic formal language assessment during the follow-up of all children with subcortical infarct involving the dominant hemisphere. (J Child Neurol 2005;20:1003—1008).

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