Topical features of speech disorders in children with focal cortical dysplasia and symptomatic epilepsy
We studied speech function in 11 patients with focal cortical dysplasia (FCD) of different localization. The character of speech disorders was strongly correlated with the time of seizure onset and their frequency, while the localization of dysplasia did not play a significant role. The speech remained intact during seizures in the school age and during the relatively rare (weekly or monthly) seizures. The complete disappearance of speech after the period of normal development occurred in the daily multiple secondary-generalized seizures and resembled the previously described Landau-Kleffner syndrome ("aphasia-epilepsy"). Based on the literature and own data, the authors suggest that such global speech disorders can not be considered as aphasia, i.e., the disorder due to the focal lesions of speech brain areas. The authors did not reject the possibility of the development of aphasia in epileptic patients but only in those cases when the epileptic activity confined to mostly speech areas. Global speech disorders (up to the complete disappearance of impressive and expressive speech) at any localization of epileptic focus developed during the negative rearrangement of the speech functional system as a whole. These speech disorders are often accompanied by the acquired epileptic frontal syndrome. That is, in the first place are the most phylo- and ontogenetically young functional systems, namely, speech and regulatory functions, the damage of which emerges as a frontal syndrome. At the same time, the old consolidated pre-speech connections remain. Presumably, in this view, in cases of global speech disorders and speech disappearance, it is more correctly to substitute the terms "aphasia-epilepsy" and "total aphasia" for the familiar term "regression of speech development".