Acquired Expressive Dysphasia with Paroxysmal EEG Abnormalities Treated with ACTH-Z. Report of Two Cases

Abstract

This report concerns two six-year-old right-handed boys who had acqired expressive speech disturbance associated with paroxysmal EEG abnormalities. The EEG showed frequent spike and wave discharges maximally in the right mid-temporal region with transmission to the other area of the right hemisphere during wakefulness and subclinical bioelectrical status during sleep.
They were succesfully treated with ACTH-Z. But the EEG abnormalities and speech disturbance recurred about one month later, which again responded to ACTH-Z therapy. In these patients the degree of speech disturbance paralleled the EEG abnormalities. Persistent focal EEG abnormalities might be a cause of speech disturbance. But not only cortical but also subcortical dysfunction might be involved in this condition in the light of diffuse continuous sharp and slow wave discharges during sleep. At the present time the cause of the syndrome remains unknown.