Language Lateralization in Children with Benign Partial Epilepsy

Abstract

To investigate the relationship between epilepsy and hemispheric asymmetries for language, a dual-task procedure was used to assess language lateralization in children with benign rolandic childhood epilepsy. In the sample selection, care was taken to include factors believed to influence both the mental capabilities of epileptic patients and the individual functional cerebral organization. Results suggest that the interhemispheric prevalence pattern is related to the focus site. Controls as well as epileptic patients with a right hemispheric focus showed the expected left language lateralization; conversely, children with a left unilateral focus showed a different pattern of functional representation, suggesting an involvement of the right hemisphere in language mechanisms. It is emphasized that this atypical cerebral organization is found in subjects with no structural lesion and no therapy. It seems likely that the presence of a focal epileptic activity itself can alter the cerebral mechanisms underlying cognitive functions. A relationship between this modified hemispheric specialization and subtle neuropsychological dysfunctions observed in the children with focal epilepsy is suggested.

Eletrencefalograma quatitativo em crianças com epilepsia benigna da infância com pontas centrotemporais: análise de freqüências

“…Embora a ausência de déficit neurológico e intelectual faça parte da definição da EBICT 6 , déficits neuropsicológicos em testes especiais têm sido encontrados por vários autores 4,9-Arq Neuropsiquiatr 2004;62(2-B) 457 14 . Na gênese dessas disfunções o papel das descargas epileptiformes foi realçado por vários autores 9,11,[14][15][16][17] . No entanto, a relação entre número de descargas e alterações nos testes neuropsicológicos é controvertida 13,15 .…”

Troubles cognitifs et comportementaux chez l’enfant ayant une épilepsie bénigne à pointes centro-temporales

“…Lorsqu'elles sont unilatérales, elles se retrouvent plus souvent dans l'hémisphère gauche que dans l'hémisphère droit (p.ex. 64% vs 36%) (Piccirilli, D'Alessandro, Tiacci & Ferroni, 1988).…”

“…Certains auteurs montrent en effet que la topographie du foyer épileptique (gauche vs droit) aurait une incidence sur le type d'atteintes cognitives transitoires secondaires (verbales vs visuospatiales) (Binnie, 1996). De plus, les travaux de Piccirilli et al (1988) et D'Alessandro et al (1990 ont montré le rôle de la topographie du foyer dans la latéralisation cérébrale du langage. Chez des sujets droitiers avec foyer épileptique gauche, en phase active, ils ont remarqué une latéralisation atypique du langage.…”

A Review of the Not So Benign- Benign Childhood Epilepsy with Centrotemporal Spikes

“…Children with rolandic seizures may develop usually mild and reversible linguistic, cognitive and behavioural abnormalities during the active phase of the disease [46]. These abnormalities are expected due to the superimposition of the cortical areas for language with those of the RS, which concentrate in the lower part of the rolandic area and in the sylvian region, with an eventual extension into the temporal cortex and adjacent parietal region [47,48]. Benign rolandic epilepsy disrupts development in childhood only if it interferes with the child's chances for normal friendships.…”