title: BECTS evolving to Landau-Kleffner Syndrome and back by subsequent recovery: a longitudinal language reorganization case study using fMRI, source EEG, and neuropsychological testing.
abstract: By means of a longitudinal case study, we demonstrated the course of cerebral reorganization of language representation due to epilepsy in a child with benign epilepsy with centro-temporal spikes (BECTS) evolving to Landau-Kleffner Syndrome (LKS) and returning to BECTS. The child underwent the following procedures at the ages of 8.2, 8.6, and 9.3 years: 3D source EEG imaging, language fMRI (sentence generation and reading), and neuropsychological testing. He had a follow-up testing at the age of 10.8 years. Further, 24-h EEGs were regularly performed. At the age of around 8 years, the child was diagnosed initially with left-hemispheric BECTS, which evolved to LKS with continuous bilateral discharges. In addition, 3D source imaging data revealed a left anterior temporal focus with a spreading to the right parietal and left centro-parietal areas. The patient had verbal agnosia with poor verbal yet good performance indices. Functional magnetic resonance imaging (fMRI) showed a left-hemispheric reading network but sentence generation was impossible to perform. After initiation of adequate treatment, continuous discharges disappeared, and only very rare left-hemispheric centro-temporal spikes remained. Verbal IQ and performance IQ increased at the age of 8.6 years. Functional magnetic resonance imaging showed, at this time, a right-hemispheric language activation pattern for sentence generation and reading. At the ages of 9.3 and 10.8 years, language tasks remained right-hemispheric and verbal IQ remained stable, but right-hemispheric non-verbal functions decreased due to possible crowding-out mechanisms.
authors: Division of Pediatric Neurology and Developmental Medicine, University Children's Hospital Basel, Switzerland. alexandre.datta@ukbb.ch
authors: A N
authors: AN
authors: Datta
authors: N
authors: N
authors: Oser
authors: G P
authors: GP
authors: Ramelli
authors: N Zanda
authors: NZ
authors: Gobbin
authors: G
authors: G
authors: Lantz
authors: I K
authors: IK
authors: Penner
authors: P
authors: P
authors: Weber
mesh_terms: D001921:Brain / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D002648:Child; D003072:Cognition Disorders / Q000209:etiology*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007361:Intelligence Tests; D018887:Landau-Kleffner Syndrome / Q000150:complications* / Q000473:pathology*; D007805:Language Development Disorders / Q000209:etiology*; D007807:Language Tests; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D020127:Recovery of Function / Q000502:physiology*
chemical_list: D010100:Oxygen