Language outcome following multiple subpial transection for Landau-Kleffner syndrome

Landau-Kleffner syndrome is an acquired epileptic aphasia occurring in norm al children who lose previously acquired speech and language abilities. Alt hough some children recover some of these abilities, many children with Lan dau-Kleffner syndrome have significant language impairments that persist. M ultiple subpial transection is a surgical technique that has been proposed as an appropriate treatment for Landau-Kleffner syndrome in that it, is des igned to eliminate the capacity of cortical tissue to generate seizures or subclinical epileptiform activity, while preserving the cortical functions subserved by that tissue. We report on the speech and language outcome of 1 4 children who underwent multiple subpial transection for treatment of Land au-Kleffner syndrome. Eleven children demonstrated significant postoperativ e improvement on measures of receptive or expressive vocabulary. Results in dicate that early diagnosis and treatment optimize outcome, and that gains in language function are most likely to be seen years, rather than months, after surgery. Since an appropriate control group was not available, and th at the best predictor of postoperative improvements in language function wa s that of length of time since surgery, these data might best be used as a benchmark against ether Landau-Kleffner syndrome outcome studies. We conclu de that multiple subpial transection may he useful in allowing for a restor ation of speech and language abilities in children diagnosed with Landau-Kl effner syndrome.