Journal of Pediatric Epilepsy 2017; 06(02): 115-118
DOI: 10.1055/s-0037-1599192
Case Report
Georg Thieme Verlag KG Stuttgart · New York

The Implication of the Thalamus in Speech Disturbance in a Boy with Rolandic Epilepsy

Hideaki Kanemura
1   Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
,
Fumikazu Sano
1   Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
,
Tetsuo Ohyama
1   Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
,
Kanji Sugita
1   Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
,
Masao Aihara
2   Graduate Faculty of Interdisciplinary Research, Graduate School, University of Yamanashi, Yamanashi, Japan
› Author Affiliations
Further Information

Publication History

14 December 2015

11 May 2016

Publication Date:
02 March 2017 (online)

Abstract

Transient oromotor deficits in children with rolandic epilepsy (RE) have been described in literature. It has been reported that thalamic aphasia can be caused by thalamic infarction or hemorrhage; however, it has never been reported that thalamic aphasia can be caused by epileptic disorders. Here, we describe a 6-year-old right-handed boy who showed transient oromotor deficits and speech disturbance with worsening of both epileptic seizure and paroxysmal discharges on electroencephalogram. He had paucity of spontaneous speech, feeble speech, arrest of speech, and anomia, but his repetition skills were intact. A single-photon emission computed tomography (SPECT) scan using technetium-99m hexamethyl propylene amine oxime (99mTc-HMPAO) to measure regional cerebral blood flow showed a reduction in flow in the left thalamus and ipsilateral frontotemporal areas, which appeared concurrently with the speech dysfunction. We suggest that speech disturbance such as thalamic aphasia, which is similar to the symptoms of Landau-Kleffner syndrome, may occur due to epileptic disorders such as RE. It may be possible to miss speech disturbance implicated in the thalamus in cases complicated by oromotor dysfunction. It is important that speech disturbance implicated in the thalamus is not overlooked in patients with RE showing an atypical course.

 
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