Article

Language outcome following multiple subpial transection for Landau–Kleffner syndrome

Christopher L. Grote1, Patricia Van Slyke2 and Jo-Ann B. Hoeppner1,3

1 Departments of Psychology and 2 Communication Disorders and Sciences, Rush-Presbyterian-St Luke's Medical Center, Chicago, Illinois and 3 Department of Pediatrics, Evanston Northwest Healthcare, Evanston, USA

Correspondence to: Christopher Grote, Rush-Presbyterian-St Luke's Medical Center, 1653 W. Congress Parkway, Chicago, IL 60612, USA E-mail: cgrote@rush.edu

Landau–Kleffner syndrome is an acquired epileptic aphasia occurring in
normal children who lose previously acquired speech and language
abilities. Although some children recover some of these abilities, many
children with Landau–Kleffner syndrome have significant language
impairments that persist. Multiple subpial transection is a surgical
technique that has been proposed as an appropriate treatment for
Landau–Kleffner syndrome in that it is designed 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 14 children who underwent
multiple subpial transection for treatment of Landau–Kleffner syndrome.
Eleven children demonstrated significant postoperative improvement on
measures of receptive or expressive vocabulary. Results indicate 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 that
the best predictor of postoperative improvements in language function was
that of length of time since surgery, these data might best be used as a
benchmark against other Landau–Kleffner syndrome outcome studies. We
conclude that multiple subpial transection may be useful in allowing for a
restoration of speech and language abilities in children diagnosed with
Landau–Kleffner syndrome.