A seven year old right-handed boy with a one year history of language disorder associated with clinical seizures and paroxysmal EEG is reported from the Division de Neurologia, Instituto Nacional de Neurologia Y Neurocirugia, Mexico, D.F. He had normal speech and comprehension up to age six when he developed several brief episodes of loss of awareness and unresponsiveness associated with automatic movements of the hands, recurring more than 20 times a day. Two months later he did not respond to calls and did not comprehend stories read to him. His speech became telegraphic. CT and MRI revealed a small cysticercus deep in the left Sylvian fissure. An EEG showed sharp and slow wave complexes over the left centrotemporal regions with spread to the right side. Treatment with the anticysticercal drug Albendazole resulted in reduction in size of the cyst, valproate controlled the seizures, and the language disorder improved. Follow-up at six months showed no recurrence. [1]

COMMENT. Deonna T and associates from the Pediatric Department, Lausanne, Switzerland, report an adult follow-up study of seven patients with acquired aphasia-epilepsy syndrome beginning in childhood [2]. One man had recovered completely, one had normal oral language but was severely dyslexic, one recovered normal comprehension but had severe expressive language problems, four had absent language comprehension and lack of expressive speech. Only one had learned and is using sign language with some efficiency, and none had developed functional written language. Attempts to offer a substitutive language to children with acquired aphasia-epilepsy syndrome were not very successful. Isolated reports of improvement with anticonvulsant drug treatment justified further trials. Ansink BJJ et al from the Sint Lucas Ziekenhuis, Amsterdam, the Netherlands, report a child who developed seizures with fever at 20 months of age. The fever was caused by pneumonia. Four months later she had fever and status epilepticus which were followed by abnormal behavior and aphasia. The aphasia was complicated by visual agnosia and spatial disturbances. The EEG showed multifocal epileptic activity. Treatment with valproic acid controlled the seizures and language functions recovered slowly. At a recent meeting of the American Epilepsy Society there were two papers on the Landau-Kleffner syndrome: 1) Marescaux C et al from Strasbourg, France and Liege, Belgium described two patients with a syndrome of continuous spike wave discharges during sleep associated with aphasia; and 2) Morrell F et al from Rush Medical College, Chicago, reported two patients with the syndrome who were treated successfully by multiple transection.