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When Epilepsy Interferes With Word Comprehension: Findings in Landau-Kleffner Syndrome

Department of Pediatrics, University of Texas-Houston Medical School, Houston, Texas, Department of Neurology, University of Texas-Houston Medical School, Houston, Texas, Department of Neurosurgery, University of Texas-Houston Medical School, Houston, Texas, eduardo.m.castillo{at}uth.tmc.edu

Ian J. Butler, MD

Department of Pediatrics, , University of Texas-Houston Medical School, Houston, Texas

James E. Baumgartner, MD

Department of Surgery, University of Texas-Houston Medical School, Houston, Texas

Antony Passaro, BA

Department of Pediatrics, University of Texas-Houston Medical School, Houston, Texas

Andrew C. Papanicolaou, PhD

Department of Pediatrics, University of Texas-Houston Medical School, Houston, Texas, Department of Neurology, University of Texas-Houston Medical School, Houston, Texas, Department of Neurosurgery, University of Texas-Houston Medical School, Houston, Texas

Landau-Kleffner syndrome is characterized by a regression in receptive language. The factors that affect the clinical expression of this syndrome remain unclear. This study presents neuroimaging findings in 2 patients showing different clinical evolutions. Linguistic regression persisted in 1 patient and evolved positively in the other. In patient A (with severe linguistic regression) there was an overlap between areas engaged during word recognition and those involved in generating the epileptiform activity; in patient B (with better linguistic evolution), receptive language was predominantly represented in the right hemisphere (unaffected). Patient A underwent multiple subpial transections. The 2-year follow-up indicated linguistic improvement, absence of epileptiform activity, and activation of the left temporal cortex during word comprehension. These results suggest that the resolution of the linguistic deficit in Landau-Kleffner syndrome may be modulated by the language-specific cortex freed from interfering epileptiform activity or by reorganization of the receptive language cortex triggered by the epileptic activity.

Key Words: Landau-Kleffner syndrome • magnetoencephalography • language mapping

Journal of Child Neurology, Vol. 23, No. 1, 97-101 (2008)
DOI: 10.1177/0883073807308701


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