Language Dysfunction in Pediatric Epilepsy

Fiona M Baumer, Aaron L Cardon, Brenda E Porter, Fiona M Baumer, Aaron L Cardon, Brenda E Porter

No abstract available

Keywords: Landau-Kleffner syndrome; acquired language disorders; epilepsy; epilepsy surgery; epilepsy, rolandic; functional neuroimaging; language; language development; status epilepticus, electrographic.

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1

Diagrammatic representation of primary language areas on anatomical T2-weighted FLAIR MRI and 3D reconstruction images (110), highlighting left temporal lobe (Wernicke’s area in posterior temporal region, vertical arrows/dotted hatching), frontal lobe (Broca’s area in middle frontal region, horizontal arrows/diagonal hatching), and the white matter (arcuate fasciculus, gradient shading) that connects these regions. Historically, language has been conceptualized as a lateralized function, with dominance typically in the left hemisphere. Functional magnetic resonance imaging (fMRI) studies confirm that language is a left-hemispheric dominant process in the vast majority of healthy adults (111), but also that language requires input from distributed networks, including homologous right hemispheric regions.

Figure 2

Electrical Status Epilepticus of Sleep (ESES). The EEG of a young girl with language regression; six seconds each of wakefulness (left panel, A) and slow wave sleep (right panel, B). In sleep, the EEG is similar in appearance to that seen in clinical status epilepticus (bipolor longitudinal montage; 10 uvolts/mm, low filter 0.1 Hz, high filter 70 Hz). In ESES, spikes are typically bitemporal, but may be lateralized, and sleep architecture is interrupted if present. Here, arrows indicate left tempo-parietal spikes with a field to the right hemisphere. When an EEG is evaluated for ESES, the percentage of seconds of non-REM sleep containing spikes is determined, with the cut-off for diagnosis varying between 50–85%.(16)