Cognitive functions and epileptic activity

Epilepsy, and its treatment, can affect the development and use of language in a number of different ways. The seizures may be a symptom of a lesion i n areas of the brain essential for language function, and the complications of both the seizures and of the drugs can interfere with learning. However , the purpose of this review is to consider the role of epileptic activity as demonstrated by electrical discharges in the electroencephalogram (EEG), whether these are accompanied by overt seizures or not, on cerebral functi on especially that of language. The Landau-Kleffner, the continuous spike-waves during sleep, and the benig n epilepsy of childhood with Rolandic spikes syndromes are considered; as w ell as the evidence of epileptic discharges affecting language development. If there are doubts that a patient is suffering from epilepsy the diagnosis may be difficult; and anyone involved in the treatment of language disorde rs should keep this possibility in mind. Particularly during childhood an E EG, awake and asleep, should be an important part of the assessment of both developmental and acquired dysphasia. The control of overt fits may be relatively easy, but drugs are not so effe ctive in controlling the epileptic activity in the EEG. The treatment of su ch discharges used to be discouraged, but the evidence is now strongly in f avour of employing both medical and surgical treatment. The results in rest oring language function are sometimes dramatic. (C) 2000 BEA Trading Ltd.