RELATIONSHIP BETWEEN LANGUAGE DISABILITIES AND BENIGN ROLANDIC EPILEPSY
Abstract number :
1.112
Submission category :
Year :
2005
Submission ID :
5163
Source :
www.aesnet.org
Presentation date :
12/3/2005 12:00:00 AM
Published date :
Dec 2, 2005, 06:00 AM
Authors :
Bruce Roseman, Marcello Lancman, Elaine Y. Kang, and Madelyn S. Herman
We have been taught that benign rolandic epilepsy of childhood is [quot]benign[quot] because there are no documented structural abnormalities of the brain, and with time the vast majority of children outgrew their epilepsy without treatment. Perhaps we were not evaluating all the clinical problems associated with this syndrome. Having attended the last AES meeting and wanting to challenge myself as a private practioner, I asked the following questions: (1) Do I really learn anything by attending these meetings? (2) How do I know I am learning? (3) Is there a way of measuring this newly acquired information? (4) Will this newly acquired knowledge be of benefit to my patients? (5) Will there be any negative consequences? (6) Will I return to my practice ready to assume more complex diagnostic problems, only to be told by office manager that managed care does not reimburse for time spent on complex illness? (7) Will I be asked to leave my practice or voted a salary reduction because I am no longer cost effective on a time basis?
At the 2004 AES meeting, I was made aware that there was a subgroup of children with benign rolandic epilepsy who continued to have persistent language disabilities, requiring special education, long after their seizures had ceased. To answer the above questions, I chose to study the relationship between language disabilities and benign rolandic epilepsy because of the many learning disabled children with epilepsy that I follow in my practice. Thirty patients who presented with new-onset seizures were evaluated with awake and asleep EEG. Those whose EEG findings were consistent with benign rolandic epilepsy were further evaluated for language disabilities, by examining their school records.
In addition, ten patients who initially presented with language disability without a history of seizure were evaluated with awake and asleep EEGs. (1): Eighteen of the thirty patients (60%) with new-onset seizures had EEG criteria consistent with benign rolandic epilepsy.
(2): Twelve of the eighteen patients (66%) diagnosed with benign rolandic epilepsy had significant language disabilities requiring special education.
(3): Five of the ten patients (50%) presenting with language disabilities without seizures had EEG evidence of benign rolandic epilepsy. Prior to attending the 2004 AES meeting, the differential diagnosis for acquired epileptic aphasia was limited to the Landau-Kleffner syndrome and the syndrome of continuous spike and slow wave during sleep. Having posed the question [ldquo]do I really learn anything from these meetings?[rdquo] - the answer is overwhelmingly yes. I measured the immense value of the meeting, by showing there is a strong association between benign rolandic epilepsy and language disabilities.