Language disorders associated with paroxysmal abnormalities during NREM sleep after very early brain lesions

We investigated the role of paroxysmal abnormalities in NREM sleep in children with early brain lesions and language disorders. I-lie presence of epilepsy has been often associated to an unfavorable prognosis for cognitive and language development in children with early brain lesions. We assessed language development in six children with pre- or perinatal brain lesions and marked language disorders by focusing oil the following variables: 1) site and side of lesion: 2) presence of epilepsy; 3) presence of paroxysmal abnormalities in NREM sleep: 4) presence of a clinical picture of epilepsy and language regression. Cases 1, 2 and 3 presented with many epileptic episodes. The remaining three cases showed language disorders in the absence of seizures and antiepileptic therapy. In all cases. we found a high percentage of epileptiform abnormalities in NREM sleep. Cases 1. 2 and 3 present with a clinical picture of acquired aphasia associated to epilepsy in the presence of a neurological lesion (Landati-Kleffner Syndrome-Like). Results confirm the unfavorable prognosis of the association of early brain lesion, epilepsy and Landau-Kleffner Syndrome for linguistic and cognitive development. The association between language disorders and/or language regression in children with early brain lesions and paroxysmal abnormalities in NREM sleep is highlighted. Our study points out the need to constantly monitor the sleep EEG of children with an early brain injury, since the presence of a relevant paroxysmal activity in sleep - even in the absence of epilepsy - seems to be correlated to poor language development.