The relationship between language disorder and epileptic seizures was examined in 109 children, ages 5-17 years, attending a national center for epilepsy over a 4 year period and at the University of Manchester, UK. Median age at onset of epilepsy was 2 years 5 months, and seizure onset was before 6 years of age in 89% of the cohort. Of the 46 (42%) children with language disorders in the research sample, 30 had localization-related epilepsies and an additional 3 were unclassified. Less than 18% had generalized seizures. Twelve had Lennox-Gastaut syndrome, 7 temporal lobe epilepsy, 5 frontal lobe epilepsy, and 3 had a history of West syndrome. Children with focal epilepsies were 30% more likely to have language disorder than other language disability subtypes. Children with simple or complex partial seizures had an increased risk of language disorder. A routine screening test to check for language impairment is recommended in children with focal epilepsies. Early detection and therapy may prevent the development of cognitive, emotional, and behavior problems. 
COMMENT. In addition to specific epileptic aphasias (Landau-Kleffner syndrome), language disorders occur with increased incidence in children with focal epilepsies. In the management of children with focal simple or complex partial seizures, an evaluation of language development is important. One in 5 children with language impairment have seizures (Robinson 1991), compared to a 5-7% seizure prevalence in the general childhood population. Reasons postulated for this association include altered brain function due to seizures, a genetic association, and a link between antecedent brain abnormalities and seizures leading to cerebral dysfunction in language centers.
Developmental language disorder associated with varying degrees of polymicrogyria is discussed in Ped Neur Briefs August 2002;16:58. An MRI should be considered in children with language disorder and focal seizures.