The role of epilepsy in early language development in a child with a congenital lesion in the right hemisphere

• Published in: Developmental medicine and child neurology Vol. 50; no. 11; pp. 870 - 875
• Main Authors: Mayor‐Dubois, C, Maeder‐Ingvar, M, Deonna, T, Roulet‐Perez, E
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-11-2008; Wiley-Blackwell; Mac Keith Press
• Subjects: Anticonvulsants - therapeutic use; Birth; Brain - pathology; Brain - physiopathology; Brain Hemisphere Functions; Child; Cognition Disorders - complications; Cognition Disorders - diagnosis; Cognitive Development; Correlation; Delayed Speech; Diagnostic Tests; Electroencephalography; Epilepsy; Epilepsy - complications; Epilepsy - drug therapy; Epilepsy - physiopathology; Functional Laterality - physiology; Grade 1; Grade 2; Humans; Infant; Infants; Language Acquisition; Language Development Disorders - complications; Language Development Disorders - diagnosis; Language Processing; Language Skills; Language Tests; Longitudinal Studies; Male; Males; Neurological Impairments; Neuropsychological Tests; Pregnancy; Seizures; Severity of Illness Index; Valproic Acid - therapeutic use; Young Children
• ISSN: 0012-1622; 1469-8749
• DOI: 10.1111/j.1469-8749.2008.03162.x

Early epilepsy is known to worsen the developmental prognosis of young children with a congenital focal brain lesion, but its direct role is often very difficult to delineate from the other variables. This requires prolonged periods of follow‐up with simultaneous serial electrophysiological and developmental assessments which are rarely obtained. We studied a male infant with a right prenatal infarct in the territory of the right middle cerebral artery resulting in a left spastic hemiparesis, and an epileptic disorder (infantile spasms with transient right hemihypsarrhythmia and focal seizures) from the age of 7 months until the age of 4 years. Pregnancy and delivery were normal. A dissociated delay of early language acquisition affecting mainly comprehension without any autistic features was documented. This delay was much more severe than usually expected in children with early focal lesions, and its evolution, with catch‐up to normal, was correlated with the active phase of the epilepsy. We postulate that the epilepsy specifically amplified a pattern of delayed language emergence, mainly affecting lexical comprehension, reported in children with early right hemisphere damage.