Language outcome following multiple subpial transection for Landau-Kleffner syndrome
Language outcome following multiple subpial transection for Landau-Kleffner syndrome
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DOI：
10.1093/brain/122.3.561
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发表时间：
1999-03-01
期刊：
影响因子：
14.5
通讯作者：
Hoeppner, JAB
中科院分区：
文献类型：
--
作者：
Grote, CL;Van Slyke, P;Hoeppner, JAB
Landau-Kleffner综合征是一种后天癫痫性失语症，发生在失去先前获得的言语和语言能力的正常儿童身上。虽然有些孩子恢复了其中的一些能力，但许多患有Landau-Kleffner综合征的孩子仍然存在严重的语言障碍。多处软膜下横切是一种被提议作为Landau-Kleffner综合征的适当治疗方法的手术技术，其设计旨在消除皮质组织产生癫痫发作或亚临床癫痫样活动的能力，同时保留该组织所提供的皮质功能。我们报告了14名接受多软膜下横切术治疗Landau-Kleffner综合征的儿童的言语和语言结果。11名儿童在接受性或表达性词汇方面表现出显着的术后改善。结果表明，早期诊断和治疗可以优化结果，并且语言功能的改善最有可能在手术后数年而不是数月内看到。由于没有合适的对照组，并且术后语言功能改善的最佳预测因素是手术后的时间长度，因此这些数据最好用作Landau-Kleffner综合征结局研究的基准。我们的结论是，多软膜下横切可能是有用的，允许恢复言语和语言能力的儿童诊断为Landau-Kleffner综合征。
Landau-Kleffner syndrome is an acquired epileptic aphasia occurring in normal children who lose previously acquired speech and language abilities. Although some children recover some of these abilities, many children with Landau-Kleffner syndrome have significant language impairments that persist. Multiple subpial transection is a surgical technique that has been proposed as an appropriate treatment for Landau-Kleffner syndrome in that it, is designed to eliminate the capacity of cortical tissue to generate seizures or subclinical epileptiform activity, while preserving the cortical functions subserved by that tissue. We report on the speech and language outcome of 14 children who underwent multiple subpial transection for treatment of Landau-Kleffner syndrome. Eleven children demonstrated significant postoperative improvement on measures of receptive or expressive vocabulary. Results indicate that early diagnosis and treatment optimize outcome, and that gains in language function are most likely to be seen years, rather than months, after surgery. Since an appropriate control group was not available, and that the best predictor of postoperative improvements in language function was that of length of time since surgery, these data might best be used as a benchmark against ether Landau-Kleffner syndrome outcome studies. We conclude that multiple subpial transection may he useful in allowing for a restoration of speech and language abilities in children diagnosed with Landau-Kleffner syndrome.