SURGICAL-TREATMENT OF SEVERE AUTISTIC REGRESSION IN CHILDHOOD EPILEPSY

We report 2 children with partial epilepsy who manifested social and l anguage regression and partial recovery after surgical treatment. One child had seizures since the first 2 weeks of life, caused by a right temporal dysembryoplastic neuroepithelial tumor and regression in the latter part of the first year; seizures were relieved and some functio ns were recovered after temporal lobe resection at 12 months of age. T he second child developed epilepsy at 3 years 3 months, and between 5 years 9 months and 6 years 1 month he became aphasic (Landau-Kleffner syndrome) and lost social functioning, manifesting a very severe behav ior disorder. He exhibited a significant improvement in communication, social functioning, and behavior after left multiple subpial transect ions. Both children manifested evidence of subclinical seizure activit y in both temporal lobes. Their clinical picture was one of combined l anguage and autistic regression, and the autistic features demonstrate d a clear response to surgical treatment. We suggest that in pediatric epilepsy surgical programs, autistic regression should prompt urgent investigation if drug treatment is not effective. (C) 1997 by Elsevier Science Inc.