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Boletín médico del Hospital Infantil de México

versión impresa ISSN 1665-1146

Resumen

CAMPOS GUEVARA, Verónica et al. Use of flunarizine in a case of Landau-Kleffner syndrome. Bol. Med. Hosp. Infant. Mex. [online]. 2011, vol.68, n.1, pp.48-53. ISSN 1665-1146.

Background. Landau-Kleffner syndrome is characterized by acquired aphasia and electroencephalographic abnormalities during wake-fulness and sleep. These abnormalities can be solved with anticonvulsive medications, but speech and behavioral problems cannot be treated using this therapy. Instead, there are reports that indicate that treatment with high-dose corticosteroids during early stages of the disease improves the speech difficulties. Use of calcium antagonists has also been proposed as possible treatment. Case report. We report the case of a 5-year-old patient with normal development until the age of 2 years. At that time, the parents observed loss of spontaneous acquired speech. During neurological evaluation, the child showed abundant echolalia and indifference to external stimuli. Electroencephalogram showed sharp waves and generalized slow spike-wave complexes of 3-4 Hz during sleep. We began treatment with prednisone and valproic acid for 1 month; flunarizine was added. After 4 months of treatment, the patient showed speech improvement. Conclusions. Our case has the characteristic clinical and electroencephalographic findings of Landau-Kleffner syndrome. We observed significant symptom improvement when flunarizine was added to the treatment. This evidence offers support for the use of a calcium antagonist as possible therapy, which may help setting the way for future controlled studies in order to finally establish its utility with this illness.

Palabras clave : Landau-Kleffner syndrome; acquired aphasia; calcium-antagonist; flunarizine; electroencephalogram; spike wave complexes.

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