ABSTRACT
Benign epilepsy with centrotemporal spikes (BECTS) is associated with language disturbances during the active phase of the seizure disorder. However, it is not yet known whether these deficits are reversible or have long-term impact on the development of language skills. We report on a study conducted in 13 patients in remission from BECTS and 13 age-matched controls, who underwent neuropsychological assessments. We also recorded event-related potentials (ERPs) during a verb generation task, to determine cortical lateralization of language. The BECTS group showed significant language deficits compared to controls as well as a pattern of atypical ERP lateralization in frontal regions. These findings support the view that BECTS in childhood may lead to enduring effects on brain maturation and language development.
Subject(s)
Epilepsy, Rolandic/physiopathology , Functional Laterality , Language Development Disorders/etiology , Adolescent , Evoked Potentials , Female , Humans , Male , Young AdultABSTRACT
BACKGROUND: Continuous spike-waves during slow sleep syndrome (CSWSS) is a rare epileptic syndrome occurring in children, which is characterized by the association of epilepsy, neuropsychological disorders, and abnormal paroxysmal electroencephalographic (EEG) discharges activated by sleep. Language can be affected but, to date, language disorders and their long-term outcome have been documented only rarely. PURPOSES: Description of language impairment in patients with the CSWSS. METHODS: We performed a detailed language testing in 10 right-handed children and adolescents with the CSWSS. Their pragmatic performance was compared to that of a control population of 36 children aged 6-10 years. RESULTS: Patients with CSWSS had lower scores in tests measuring their lexical, morphosyntactic, and pragmatic skills compared to controls. Comprehension remains unaffected. In addition, language impairment was found to be just as severe in patients in remission as those still in an active phase. CONCLUSIONS: We found severe language impairments in lexical and syntactic skills. The language profile is different from that observed in the Landau-Kleffner syndrome. Moreover patients in remission and those in an active phase of the CSWSS have the same language impairment profiles. This confirms the poor long-term neuropsychological prognosis. Our results raise points about the relationship between epileptic activity and language development. This pilot study underscores the need to assess language, and especially pragmatic skills, and to study long-term outcome in such childhood epileptic syndromes.
Subject(s)
Electroencephalography/statistics & numerical data , Epilepsy/diagnosis , Language Development , Language Disorders/diagnosis , Neuropsychological Tests/statistics & numerical data , Sleep Wake Disorders/diagnosis , Adolescent , Adult , Cerebral Cortex/physiopathology , Child , Comorbidity , Epilepsy/epidemiology , Epilepsy/physiopathology , Female , Humans , Intelligence Tests , Language Disorders/epidemiology , Language Disorders/physiopathology , Male , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/physiopathology , SyndromeABSTRACT
Although Benign Childhood Epilepsy with Centrotemporal Spikes (BECTS) has a good prognosis, a few studies have suggested the existence of language disorders relating to the interictal dysfunction of perisylvian language areas. In this study, we focused on language assessment in 16 children aged 6-15 currently affected by BECTS or in remission. An important proportion of children showed moderate or more severe language impairment. The most affected domains were expressive grammar and literacy skills. We found linguistic deficits during the course of epilepsy but also persistent deficits in children in remission, suggesting possible long-term effects. Our results support the hypothesis that BECTS may be associated with impairment to language and suggest the possibility of a direct link between epileptic activity and language development, and the existence of long-term consequences.
