CASE REPORT
O.C. is a 14-year-old right-handed female, born at 6 pounds, 11 ounces from a full-term gestation, to a GII, PII, 24-year-old mother, and a 28 year old father with both the pregnancy and delivery being uncomplicated. She fed and slept regularly during infancy and her motor skills developed at the appropriate times. Her language was also suitable to development as she spoke her first words at 12 months, and then at 24 months, she began combining words. When O.C. was approximately three years of age, her family began to notice disrupted language comprehension. In 1992, when O.C. was 3½ years, she was diagnosed with Landau-Kleffner Syndrome with an abnormal EEG (cf. Figure 1) and MRI within normal limits. She was treated with Depakote® which reportedly improved her language skills.
O.C.’s mother reported that O.C. fell on a cement pavement at 14 months on her head, which rendered her unconscious. At approximately age 2 Olivia suffered from viral meningitis.
O.C.’s LKS symptoms presented with abrupt disruption in language after normal development. The results of an electroencephalogram (EEG) brain-wave abnormality indicated seizure activity. O.C. had been making minimal progress in reading. There was also impairment in her motor skills. O.C.’s level of speech was also noted to be minimal. Vocabulary was noted as an area of specific weakness represented by paraphasic two or three words utterances.
At age nine, O.C. ceased anticonvulsant medication, during which time abnormal brain activity had been present, yet untreated. O.C. also underwent trials of Methylphenidate (Ritalin) and Dexadrine, described by O.C.’s parents as having no noticeable behavioral effect, although she was subjectively “more talkative” with Ritalin.
O.C. commenced her most recent treatment program at age 14. She performed at a kindergarten level of reading and comprehension as evaluated at Brown University Medical School. O.C.’s test performance is provided in Table I and indicates across the board that O.C. at age twelve years and two months one was functioning at lower than the 1st percentile in intelligence (both performance and verbal) and in language skills as reflected in Table I.