[Epilepsies and language disorders].

Abstract

OBJECTIVE: To study the effects of the epilepsies, the seizures and electroencephalographic discharges on the cognitive function of the child, specifically his language. We consider the relationship between developmental dysphasia and epilepsy, bearing in mind that this association may occur fortuitously, as a consequence of the same cause or taking the epilepsy to be responsible for the language disorder, as seizures or continuously (epileptic aphasia). DEVELOPMENT: We assess the relation between developmental aphasia and seizure aphasia in the epilepsies, especially the syndrome of acquired epileptic aphasia of Laundau-Kleffner (LKS). Based on the findings in the literature and a personal series of nine cases, we studied their general characteristics, clinical heterogeneity, associated clinical signs and EEG changes (present in all patients); coexistence of convulsive seizures (67-90%); aetiopathogenic findings invoked but not currently conclusive; negative neuroimaging findings apart from some SPECT and PET data; differential diagnosis; clinical course and prognosis difficult to predict. The pharmacological and/or surgical treatment, complemented by logopedics and psychopedagogics (good results in < or = 50% of the cases), the unpredictable course of LKS has to be assessed cautiously. CONCLUSIONS: No direct relation can be confirmed between epilepsy and language disorders, although a relationship may be found in some cases. The hypothesis that LKS, continuous spike-and-wave during slow sleep and partial benign atypical epilepsy are the severe, moderate and mild forms of the same epileptic syndrome is generally accepted. This appears during a phase of maturation in which the brain is particularly vulnerable, and is characterized by continuous spike-and-wave complexes during slow sleep, which lead to cognitive and behaviour disorders.