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Cerebral dominance in an unusual case of Landau-Kleffner syndrome
  1. Nodee Chowdhury1,
  2. Atma Ram Bansal2,
  3. Rajeev Goyal1 and
  4. Gowathi Nikhila2
  1. 1Neurology, Medanta—The Medicity, Gurgaon, Haryana, India
  2. 2Institute of Neuroscience, Medanta, Gurgaon, Haryana, India
  1. Correspondence to Dr Atma Ram Bansal; atmarambansal{at}yahoo.com

Abstract

Landau-Kleffner syndrome (LKS) is described by the International Classification of Epileptic Syndromes since 1985 as a constellation of clinical and electrographic signs, including acquired aphasia, regression of language milestones and seizures, along with sleep-activated paroxysms on electroencephalogram which can progress to electrographic status epilepticus of sleep. In this case, a 7-year-old boy presented with an atypical history of new-onset aphasia and regression of language milestones with rare seizures. However, there was an electrographic mismatch in the form of right-sided epileptiform activity and continuous spike and wave of sleep pattern. Detailed speech analysis and perusal of the history revealed a possibly ambidextrous child with right hemispheric language dominance, and he was diagnosed with LKS and treated. This report illustrates the many pitfalls in the diagnosis and treatment of this rare epileptic syndrome.

  • epilepsy and seizures
  • neurology
  • clinical neurophysiology

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Footnotes

  • Contributors NC was responsible for collecting the history, follow-up data, EEG analysis and literature review. ARB and RG followed up the patient and came up with the treatment protocol. They continue to see him on an outpatient basis. GN was instrumental in the initial language assessment and subsequent language therapy sessions.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.