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

Research output: Contribution to journalArticlepeer-review

302 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1529-1546
Number of pages18
JournalBrain
Volume118
Issue number6
DOIs
StatePublished - Dec 1 1995

Keywords

  • Epiletogenic lesions
  • Landau-Kleffner syndrome
  • Multiple subpial transection
  • Synaptogenesis

ASJC Scopus subject areas

  • Clinical Neurology

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