[Acquired epileptic aphasia].
OBJECTIVE
To evaluate clinical and EEG features, as well as treatment and progression in fifteen patients with a diagnosis of acquired epileptic aphasia.


METHODS
The population comprised nine male and six female patients, whose mean age was 14.5 (r = 8.11-20 years). All were on routine antiepileptic drugs. Inclusion criteria were acute, subacute or chronic aphasia, lacking signs of motor deficit or demonstrable brain lesion, but displaying bilateral spikes or generalized spike-wave discharges. Throughout, sleep and waking EEG, neuroimaging, brainstem auditory evoked potentials and neuro-psychological evaluations were performed. Cortical brainstem auditory evoked potentials were carried out in ten cases.


RESULTS
Median age at onset of verbal auditory agnosia was 5.6 years (r = 1.1-8.6 years), which eleven cases developed epileptic seizures at a median age of five years. Waking and sleep EEG were abnormal but brainstem auditory evoked potentials were normal throughout. Cortical brainstem auditory evoked potentials in ten patients displayed P300 wave and vertex potential alterations. Five cases received 1-3 mg/kg/day prednisone during 6-12 months, with almost complete speech recovery in four. At the last follow-up, language impairment was mild in five patients, moderate in five and severe in three, while two children recovered normal speech.


CONCLUSIONS
Early acquired epileptic aphasia treatment is advisable with valproic acid, benzodiazepines or ethosuximide alone or in combinations, supplementary with corticoids for at least six months in the absence of clinical response and/or EEG improvement. Globally, seven out of fifteen patients overcame their speech disorder.
Caraballo
R H
RH
Servicio de Neurología, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina.
Yépez
I I
II
Soprano
A L
AL
Cersósimo
R O
RO
Medina
C
C
Fejerman
N
N
D000293:Adolescent; D000328:Adult; D001037:Aphasia / Q000150:complications* / Q000175:diagnosis*; D001143:Arousal / Q000502:physiology; D001921:Brain / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D002648:Child; D002908:Chronic Disease; D004569:Electroencephalography; D004829:Epilepsy, Generalized / Q000150:complications* / Q000175:diagnosis; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D012895:Sleep, REM / Q000502:physiology; D014057:Tomography, X-Ray Computed