Speech and language neurodevelopmental disorders in epilepsy: pathophysiologic mechanisms and therapeutic approaches

Zavadenko N.N.; Kholin A.A.; Zavadenko A.N.; Michurina E.S.

doi:https://doi.org/10.17116/jnevro2018118081118

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Abstract:

Speech and language development may be impaired in all forms of epilepsy involving specialized functional areas in the dominant cerebral hemisphere and their connections. The concept of epilepsy-aphasia clinical spectrum was recently proposed, but the notion of aphasia is quite conditional here as many of these patients demonstrate disorders of speech and language development from their infancy. Those forms of epilepsy are considered as continuum from the most severe Landau—Kleffner syndrome (LKS) and epilepsy with continuous spike-and-wave during sleep (CSWS) (also indicating as electrical status epilepticus during sleep — ESES) to intermediate epilepsy-aphasia disorders (with incomplete correspondence to diagnostic criteria of LKS and epilepsy with CSWS). The mild end of the spectrum is represented by benign childhood epilepsy with centrotemporal spikes (rolandic), which is often associated with speech and language disorders. The importance of genetic factors is discussed, including mutations in SRPX2, GRIN2A and other genes. The perspectives of individualized pharmacotherapy in epilepsy, co-morbid with neurodevelopmental disorders or impairments of speech and language development, are depending on the progress in genetic studies. In the new generation of antiepileptic drugs the positive influence on neuroplasticity mechanisms and higher cerebral functions are supposed for levetiracetam.

Keywords:

epilepsy

disorders of speech and language development

neurodevelopmental disorders

genetic diagnosis

neuroplasticity

multi-modal therapy

levetiracetam

Authors:

Zavadenko N.N.

Kafedra nevrologii i neĭrokhirurgii pediatricheskogo fakulteta Rossiĭskogo gosudarstvennogo meditsinskogo universiteta, Moskva

Kholin A.A.

Kafedra nervnykh bolezneĭ pediatricheskogo fakul'teta s kursom fakul'teta usovershenstvovaniia vracheĭ Rossiĭskogo gosudarstvennogo meditsinskogo universiteta, Moskva

Zavadenko A.N.

Kafedra neonatologii FUV, NIL profilaktiki i lecheniia postgipoksicheskikh sostoianiĭ u novorozhdennykh GBOU VPO "Rossiĭskiĭ natsional'nyĭ issledovatel'skiĭ meditsinskiĭ universitet im. N.I. Pirogova" Minzdrava RF

Michurina E.S.

Pirogov Russian National Research Medical University, Moscow, Russia

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