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Surgical treatment of severe autistic regression in childhood epilepsy
B G Neville1, W F Harkness, J H Cross
1Neurosciences Unit, Institute of Child Health, London, U.K.
Insights
Surgical intervention can improve social and language regression in children with epilepsy. Prompt investigation of autistic regression is crucial if medical treatments for pediatric epilepsy are ineffective.
Area of Science:
- Pediatric Neurology
- Epileptology
- Developmental Neuroscience
Background:
- Partial epilepsy in children can lead to significant social and language regression.
- Autistic regression, characterized by loss of social and language skills, is a concerning manifestation in pediatric epilepsy.
- Subclinical seizure activity in temporal lobes can contribute to developmental regression.
Abstract:
We report 2 children with partial epilepsy who manifested social and language regression and partial recovery after surgical treatment. One child had seizures since the first 2 weeks of life, caused by a right temporal dysembryoplastic neuroepithelial tumor and regression in the latter part of the first year; seizures were relieved and some functions were recovered after temporal lobe resection at 12 months of age. The second child developed epilepsy at 3 years 3 months, and between 5 years 9 months and 6 years 1 month he became aphasic (Landau-Kleffner syndrome) and lost social functioning, manifesting a very severe behavior disorder. He exhibited a significant improvement in communication, social functioning, and behavior after left multiple subpial transections. Both children manifested evidence of subclinical seizure activity in both temporal lobes. Their clinical picture was one of combined language and autistic regression, and the autistic features demonstrated a clear response to surgical treatment. We suggest that in pediatric epilepsy surgical programs, autistic regression should prompt urgent investigation if drug treatment is not effective.