Aphasia and epilepsy in childhood

The syndrome of progressive aphasia and epilepsy in childhood is delineated. Four cases are presented, three of which show the typical gradual onset, fluctuating course and EEG changes with bilateral foci of spike and spike-wave activity, and, finally, normalization after some years of the EEG. Also the aphasia tends to subside, but often with considerable delay in relation to the other features. Neuropsychological assessment showed varying residual defects mainly on language functions. The aetiology is unknown. No pathoanatomical data on this disorder has hitherto been published. In one of the present cases a cortical biopsy was performed on suspicion of a left temporal tumour. The biopsy showed changes indicative of a slow virus infection. It is therefore suggested that the newly established language function in children particularly is vulnerable to a subchronic viral encephalitis affecting both hemispheres.