[Serial MEG change in a boy with Landau-Kleffner syndrome].
We report a 7-year-old boy with Landau-Kleffner syndrome (LKS), with emphasis on the effect of therapy and serial MEG. The equivalent current dipoles (ECDs) of spike discharges accumulated in the bilateral Heschl gyri, predominantly on the right. Although spike discharges on the scalp EEGs disappeared by treatment with clonazepam and sodium valproate, the auditory agnosia did not improve. Therapeutic trials with conventional antiepileptic drugs were unsuccessful. A high-dose corticosteroid was effective, with disappearance of ECDs, appearance of auditory evoked fields (AEF) in the bilateral Heschl gyri on MEG, and improvement of behavioral problems and amelioration of acquired aphasia. The clinical course of this patient suggests that MEG findings are useful not only in making precise diagnosis of LKS but also in assessing and predicting the effects of treatment.
Department of Pediatrics, Epilepsy Center, National Nishi-Niigata Central Hospital, Niigata. kamy@masa.go.jp
Takanori
T
Kamimura
Osamu
O
Kanazawa
Jun
J
Tohyama
Noriyuki
N
Akasaka
Makoto
M
Uchiyama
D000927:Anticonvulsants / Q000008:administration & dosage; D002648:Child; D002998:Clonazepam / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005072:Evoked Potentials, Auditory; D006801:Humans; D018887:Landau-Kleffner Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D015225:Magnetoencephalography; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011239:Prednisolone / Q000008:administration & dosage; D020551:Pulse Therapy, Drug; D016896:Treatment Outcome; D014635:Valproic Acid / Q000008:administration & dosage
D000927:Anticonvulsants; D002998:Clonazepam; D014635:Valproic Acid; D011239:Prednisolone; D008775:Methylprednisolone