Abstract
Landau-Kleffner syndrome (LKS) is an acquired epileptic aphasia occurring in childhood and associated with a generally poor prognosis for recovery of speech. It is thought to be the result of an epileptogenic lesion arising in speech cortex during a critical period of development. Utilizing a new surgical technique designed to eliminate the capacity of cortical tissue to generate seizures while preserving the normal cortical physiological function, we have treated 14 children with aphasia, seizures and a severely abnormal EEG by multiple subpial transection of the epileptogenic cortex. Seven of the 14 patients (50%) have recovered age-appropriate speech, are in regular classes in school and no longer require speech therapy. Four of the 14 (29%) have shown marked improvement, are speaking and understanding verbal instruction but are still receiving speech therapy. Thus, 11 of the 14 (79%), none of whom had used language to communicate for at least 2 years, are now speaking - a rate of sustained improvement considered unusual in this disorder. This study documents the value of a treatment modality not previously used in LKS. Success depends on selection of cases having severe epileptogenic abnormality that can be demonstrated to be unilateral in origin despite a bilateral electrographic manifestation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1529-1546 |
| Number of pages | 18 |
| Journal | Brain |
| Volume | 118 |
| Issue number | 6 |
| State | Published - Dec 1995 |
| Externally published | Yes |
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Keywords
- Epileptogenic lesions
- Landau-Kleffner syndrome
- Multiple subpial transection
- Synaptogenesis
ASJC Scopus subject areas
- Neuroscience(all)
- Statistics, Probability and Uncertainty
- Applied Mathematics
- Mathematics(all)
- Statistics and Probability
- Agricultural and Biological Sciences (miscellaneous)
- Clinical Neurology
Cite this
Landau-Kleffner syndrome : Treatment with subpial intracortical transection. / Morrell, Frank; Whisler, Walter W.; Smith, Michael C.; Hoeppner, Thomas J.; De Toledo-Morrell, Leyla; Pierre-Louis, Serge J C; Kanner, Andres M; Buelow, Janice M.; Ristanovic, Ruzica; Bergen, Donna; Chez, Michael; Hasegawa, Hisanori.
In: Brain, Vol. 118, No. 6, 12.1995, p. 1529-1546.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Landau-Kleffner syndrome
T2 - Treatment with subpial intracortical transection
AU - Morrell, Frank
AU - Whisler, Walter W.
AU - Smith, Michael C.
AU - Hoeppner, Thomas J.
AU - De Toledo-Morrell, Leyla
AU - Pierre-Louis, Serge J C
AU - Kanner, Andres M
AU - Buelow, Janice M.
AU - Ristanovic, Ruzica
AU - Bergen, Donna
AU - Chez, Michael
AU - Hasegawa, Hisanori
PY - 1995/12
Y1 - 1995/12
N2 - Landau-Kleffner syndrome (LKS) is an acquired epileptic aphasia occurring in childhood and associated with a generally poor prognosis for recovery of speech. It is thought to be the result of an epileptogenic lesion arising in speech cortex during a critical period of development. Utilizing a new surgical technique designed to eliminate the capacity of cortical tissue to generate seizures while preserving the normal cortical physiological function, we have treated 14 children with aphasia, seizures and a severely abnormal EEG by multiple subpial transection of the epileptogenic cortex. Seven of the 14 patients (50%) have recovered age-appropriate speech, are in regular classes in school and no longer require speech therapy. Four of the 14 (29%) have shown marked improvement, are speaking and understanding verbal instruction but are still receiving speech therapy. Thus, 11 of the 14 (79%), none of whom had used language to communicate for at least 2 years, are now speaking - a rate of sustained improvement considered unusual in this disorder. This study documents the value of a treatment modality not previously used in LKS. Success depends on selection of cases having severe epileptogenic abnormality that can be demonstrated to be unilateral in origin despite a bilateral electrographic manifestation.
AB - Landau-Kleffner syndrome (LKS) is an acquired epileptic aphasia occurring in childhood and associated with a generally poor prognosis for recovery of speech. It is thought to be the result of an epileptogenic lesion arising in speech cortex during a critical period of development. Utilizing a new surgical technique designed to eliminate the capacity of cortical tissue to generate seizures while preserving the normal cortical physiological function, we have treated 14 children with aphasia, seizures and a severely abnormal EEG by multiple subpial transection of the epileptogenic cortex. Seven of the 14 patients (50%) have recovered age-appropriate speech, are in regular classes in school and no longer require speech therapy. Four of the 14 (29%) have shown marked improvement, are speaking and understanding verbal instruction but are still receiving speech therapy. Thus, 11 of the 14 (79%), none of whom had used language to communicate for at least 2 years, are now speaking - a rate of sustained improvement considered unusual in this disorder. This study documents the value of a treatment modality not previously used in LKS. Success depends on selection of cases having severe epileptogenic abnormality that can be demonstrated to be unilateral in origin despite a bilateral electrographic manifestation.
KW - Epileptogenic lesions
KW - Landau-Kleffner syndrome
KW - Multiple subpial transection
KW - Synaptogenesis
UR - http://www.scopus.com/inward/record.url?scp=0029564407&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029564407&partnerID=8YFLogxK
M3 - Article
C2 - 8595482
AN - SCOPUS:0029564407
VL - 118
SP - 1529
EP - 1546
JO - Brain
JF - Brain
SN - 0006-8950
IS - 6
ER -