Episodic receptive aphasia in a child with Landau-Kleffner Syndrome: PET correlates

Aimee F. Luat, Harry T. Chugani, Eishi Asano, Csaba Juhász, Gary Trock, Robert Rothermel

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

We report a four-year-old boy with Landau-Kleffner Syndrome (LKS) characterized by episodic receptive aphasia lasting for few weeks followed by gradual recovery of baseline language functions. Neuropsychological evaluation during an episode showed severe impairment in verbal skills and comprehension, but relative preservation of non-verbal skills. Although he could carry on a conversation during remission, neuropsychological evaluation demonstrated findings reflective of receptive language deficits. Prolonged EEG disclosed frequent sharp-wave activity in the left and right temporal regions but no electrographic seizures. Glucose metabolism PET scan during the fourth episode of aphasia revealed intense hypermetabolism in the left temporal neocortex. Awake EEG during the PET tracer uptake period showed 6.0 spikes/min in the left temporal region and 4.0 spikes/min in the right. A repeat PET scan during remission showed hypometabolism in the left temporal cortex. Awake EEG during the FDG uptake period showed 16.0 spikes/min in the right temporal region and 0.3 spikes/min in the left. During his fifth aphasic episode, EEG (without PET) showed 0.16 spikes/min in the right temporal region and none in the left. Intermittent short episodes of predominantly receptive aphasia with near-total recovery between episodes can be one of the clinical presentations of LKS. This case illustrates the dynamic changes of glucose metabolism in the temporal lobe during episodes of aphasia and remission in a case with LKS. The clinical course of our patient with transient EEG and PET findings suggest that glucose metabolism in LKS cannot be attributed solely to interictal epileptiform activities on scalp EEG.

Original languageEnglish
Pages (from-to)592-596
Number of pages5
JournalBrain and Development
Volume28
Issue number9
DOIs
StatePublished - Oct 2006

Keywords

  • Brain glucose metabolism PET scan
  • Interictal spikes
  • Landau-Kleffner Syndrome
  • Quantitative electroencephalography
  • Receptive aphasia

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