Klein S K, Tuchman R F, Rapin I
Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.
J Child Neurol. 2000 Jan;15(1):36-43. doi: 10.1177/088307380001500109.
Previous studies of children with Landau-Kleffner syndrome and related language-epilepsy syndromes have focused on the relationship of seizure control to language recovery. We examined the effect of premorbid language skills and behavior, as well as some characteristics of clinical seizures and electroencephalograms, on language recovery in a retrospective study of 67 children with the severe receptive and expressive language disorder, verbal auditory agnosia. Fifty-eight percent of these children had seizures, 76% were autistic, and 24% had a history of language regression after showing previously normal language skills. The duration of language loss was not influenced by the persistence of clinical seizures. Premorbid language and behavior were more predictive of language recovery in these children. Most children with normal early language (acquired verbal auditory agnosia) had onset of language loss after age 3 years, in contrast to those with abnormal early language. Children with acquired verbal auditory agnosia were more likely to show fluctuations in language skills than those in other groups. Autistic children were more likely to begin having seizures before age 3 years, and had a longer duration of language loss and lower educational placement at time of last follow-up than those with normal behavior. This study emphasizes the importance of assessing premorbid language and behavior in predicting recovery of language skills in children with language-epilepsy syndromes.
以往对患有Landau-Kleffner综合征及相关语言-癫痫综合征儿童的研究主要聚焦于癫痫控制与语言恢复之间的关系。在一项对67名患有严重感受性和表达性语言障碍、言语听觉失认症儿童的回顾性研究中，我们考察了病前语言技能和行为，以及临床癫痫发作和脑电图的一些特征对语言恢复的影响。这些儿童中58%患有癫痫，76%患有自闭症，24%在曾表现出正常语言技能后出现语言倒退。语言丧失的持续时间不受临床癫痫发作持续情况的影响。病前语言和行为对这些儿童的语言恢复更具预测性。与早期语言异常的儿童相比，大多数早期语言正常（获得性言语听觉失认症）的儿童在3岁后出现语言丧失。与其他组儿童相比，患有获得性言语听觉失认症的儿童语言技能更易出现波动。自闭症儿童比行为正常的儿童更易在3岁前开始出现癫痫发作，且在最后一次随访时语言丧失持续时间更长、教育安置水平更低。本研究强调了评估病前语言和行为对预测语言-癫痫综合征儿童语言技能恢复的重要性。
