The value of routine wake electroencephalography in children with specific language impairment was reviewed retrospectively in 111 children examined over a 10-year interval at Montreal Children’s Hospital, Quebec, Çanada. Children with known central nervous system disorders were excluded. Sleep-deprived EEG was not performed. The wake EEG was abnormal in 35 (31.5%) children, including 7 (6.3%) with epileptiform activity, and higher than that in ’normal’ children (3.54%). (NS. P=0.12). The epileptiform activity was active in 3 patients. Three (2.7%) had excessive paroxysmal activity (PA) with hyperventilation, and 3 (2.7%) had excessive PA with photic stimulation. Female gender had a small association with abnormal EEG. Two patients with epileptiform EEGs received anticonvulsant medication on parental request; subsequent EEGs but not the speech were improved. Soft neurologic signs, macrocephaly, or microcephaly were present in 21 (18.9%) children, ADHD in 15 (13.5%), and comorbid learning difficulties in 14 (12.6%). [1]

COMMENT. Wake EEG is of uncertain value in the routine diagnostic evaluation of children with specific language impairment. Definitive recommendations await further investigation with both wake and sleep EEG. A previous prospective study including both wake and sleep EEG demonstrated abnormalities in almost half of the patients (14 of 32) with developmental dysphasia, and epileptic activity in 30 of the 32 in overnight recordings [2]. Patients with receptive dysphasia were at highest risk for abnormal EEG. [3]