Intravenous therapy with methylpredisolone (20 mg/kg daily) was effective in two six-year-old children with Landau-Kleffner syndrome treated at Jichi Medical School, Tochigi, Japan. A combination of valproate and a benzodiazepine had previously resulted in decreased seizures and EEG improvement, but speech and language were not improved. After 3 consecutive daily treatments with high-dose IV corticosteroids, speech was increased and receptive language improved. After a third course of therapy, the children could speak in sentences, and their subsequent language development was sustained. [1]

COMMENT. High-dose corticosteroid therapy, administered early at the first appearance of symptoms, has been recommended in previous reports (Progress in Pediatric Neurology II, PNB Publ, 1994;pp221-226). [2, 3]