Landau-Kleffner syndrome (LKS) must be distinguished from prolonged ictal aphasia and prolonged postictal aphasia secondary to frequent seizures, each with associated ictal aphasia. For example, one patient who had had a history of transient ictal aphasia developed a prolonged (6-month) postictal transcortical motor aphasia when he began to experience several seizures per night.46 Imaging of cerebral blood flow showed diffusely depressed left hemisphere metabolism during the period of aphasia. Seizure control (with antiepileptic medications) resulted in recovery from the aphasia as well as virtual normalization of regional cerebral blood flow.
Patients with Rolandic status epilepticus and associated oromotor symptoms have been reported.47–51 A few patients with documented structural pathology, intractable epilepsy, and severe focal epileptiform activity have shown clear improvement in language that correlated with improved seizure control and decreased epileptiform activity after hemispherectomy.38,39
Reviewed and revised May 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.
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