Abstract
The patient was an 8 year-old boy who revealed clinical symptoms of Landau-Kleffner syndrome (aphasic-epileptic syndrome). Although he did not have a clinical seizure, his EEG findings consisted of multifocal centre-parietal predominant spike and wave complexes. His auditory imperception coincided with auditory agnosia, which includes both verbal and nonverbal deficits.
A positive correlation was detectable between language disability and abnormal hyperactive behavior. These two clinical features improved after methylphenidate was administered, but deteriorated after diazepam. Therefore, it could be assumed that these medications may have affected clinical symptoms by changing vigilance.
As for the etiology of Landau-Kleffner syndrome, two hypotheses have been postulated and discussed. One is “functional ablation” of language function by abnormal epileptic discharge, and the other is focal or chronic encephalitis. However, the case at hand did not accord with either of these hypotheses. He did not show a significant correlation between language function and EEG findings, which disproves direct “functional ablation” .
On the other hand, no apparent evidence of focal or chronic encephalitis existed throughout the course of the case. It is thus necessary to assume the presence of a bilateral dysfunction of some system not restricted to the temporal lobes. A dysfunction of the cortico-subcortico-reticular system may be suggested.
