Impact of childhood epilepsy on reading and phonological processing abilities.

Although children with epilepsy tend to exhibit more reading difficulties than their classmates, no systematic studies have investigated the relationship between these difficulties and epilepsy. As functional neuroimaging studies have implicated both temporal and frontal lobes in the phonological aspect of reading [K.R. Pugh, B.A. Shaywitz, S.E. Shaywitz, et al. Brain 1996;119:1221-38], seizure activity originating in either region could interfere with phonological processing, whereas generalized seizures would not disturb this function as much. To explore this hypothesis, we compared the metaphonological skills of school-aged children with either temporal lobe epilepsy (TLE), frontal lobe epilepsy (FLE), or generalized absence seizures (ABS) with those of healthy controls. While the reading ability of all epileptic children was close to 2 years behind expectations, children with TLE did not differ from the controls on phonological tasks. In contrast, children with FLE exhibited significant deficits, whereas children with ABS showed difficulties restricted to phonemic segmentation. The results suggest that FLE and, to a lesser extent, generalized seizures may interfere with phonological processing, whereas TLE may affect other aspects of reading.

Impact of temporal lobe epilepsy on phonological processing and reading: a case study of identical twins.

In order to evaluate the possible consequences of temporal lobe epilepsy on reading acquisition, we first compared the reading skills and phonological awareness abilities in a set of 13-year-old identical twins, one of whom is affected by temporal lobe epilepsy (LB). We then compared their performances to those of an age- and IQ-matched control group. Both siblings have an intellectual quotient above average as well as normal memory and linguistic abilities. Results showed that the reading age of LB (assessed by the Lefabvrais French reading test) was more than two years behind expectations whereas that of her sister was above average. Further, in contrast to her sister and healthy control subjects, LB exhibited specific deficits in elaborate metaphonological awareness abilities (non-word repetition, rhyme production, phonemic segmentation and syllabic inversion). These could be linked to temporal lobe dysfunction, thus confirming the important role of the temporal lobes in reading acquisition.