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Landau—Kleffner syndrome
Treatment with subpial intracortical transection

Frank Morrell, Walter W. Whisler, Michael C. Smith, Thomas J. Hoeppner, Leyla de Toledo-Morrell, Serge J. C. Pierre-Louis, Andres M. Kanner, Janice M. Buclow, Ruzica Ristanovic, Donna Bergen, Michael Chez, Hisanori Hasegawa
DOI: http://dx.doi.org/10.1093/brain/118.6.1529 1529-1546 First published online: 1 December 1995

Summary

Summary 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

  • Landau—Kleffner syndrome
  • multiple subpial transection
  • epiletogenic lesions
  • synaptogenesis

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