Journal of Psychiatry

Differential diagnosis of Landau–Kleffner syndrome versus post encephalitis syndrome in 13 year old boy with Autism Spectrum Disorder

Euro Global Summit and Medicare Expo on Psychiatry

July 20-22, 2015 Barcelona, Spain

Luba Leontieva, Yaman Eksioglu and David Keith

Posters-Accepted Abstracts: J Psychiatry

Abstract:

Landau?Kleffner syndrome is a rare childhood neurological condition of unknown etiology involving a loss of previously acquired language skills and developmental regress with abnormal EEG. Method: We describe a case of a 13 year old boy who at the age of 3.5 years was bitten by a tick. Two months after the bite he started to rapidly loose his language and developmental skills and developed petit mal seizures which subsided after valproic acid treatment. However, the developmental delays persisted. Findings: Clinical interview of the parents revealed that the boy had some repetitive behaviors prior to the age of 3. The observation of the patient revealed the developmental age of 3 - 4 years old, with numerous repetitive vocalizations and movements along with difficulties switching activities. Long-term video EEG showed left temporal slowing, left anterior, mid, and posterior temporal and left central, parietal, occipital atypical spikes, spike and slow waves, and rare generalized bursts of spike and slow waves. MRI of the brain w/o contrast showed minimal hyperintensity in the left hippocampus and a punctate hyperintense lesion in the left temporal lobe. PET brain imaging showed mildly asymmetric diminished activity in the left basal ganglia, compared to right. The post encephalitis panel (endemic to Russia) did not find antibodies, indicating that the patient did not have encephalitis after the tick bite at the age of 3.5. The parents/teachers questionnaires revealed a very low level of adaptive functioning in all areas in a patient who met criteria for Autism Spectrum Disorder with a known medical condition (Landau-Kleffner Syndrome). Conclusion: during the course of diagnostic investigation we were able to rule out post-encephalitis syndrome and rule in Landau-Kleffner syndrome in a premorbidly Autistic child.