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Yıl:2014; Cilt: 25; Sayı: 4>> Özet
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Türk Psikiyatri Dergisi; 2014;25(4):282-286
Landau-Kleffner Sendromunda Antiepileptik Tedavi: Bir Olgu Sunumu
Ç Uğur, NS Duman, Ö Bektaş, CK Gürkan
Ankara Üniversitesi, Ankara
Giriş: Landau-Kleffner sendromu (LKS) edinsel afazi ve epileptiform EEG anormallikleri ile karakterize çok nadir rastlanan bir çocukluk çağı hastalığıdır. LKS’de hiperaktivite ve dikkat sorunları yaygın görülmekle birlikte otizm spektrum bozukluğu (OSB) belirtileri de eşlik edebilir. LKS için şu ana kadar birçok tedavi uygulanmıştır, ancak tedavi başarısı değişkenlik göstermekte, özellikle dil becerilerinin kazanımı ile ilgili olarak antiepileptik ilaçların kullanılması ile farklı sonuçlar bildirilmektedir. Diğer yandan, antiepileptik ilaç tedavisinin otizm belirtileri üzerine etkisi ile ilgili bir yayına rastlanmamıştır. Bu yazıda antiepileptik tedavi ile otizm belirtilerinde belirgin düzelme gösteren LKS’li bir erkek çocuğu sunulmuştur. Olgu Sunumu: Üç yaş on aylık erkek çocuğu sosyal ilişki kurmama, göz temasında azalma, amaçsız el hareketleri ve konuşmada gerileme yakınmaları ile çocuk ve ergen psikiyatrisi kliniğine getirildi. Hastaya nörolojik değerlendirmeler sonucunda Landau-Kleffner sendromu tanısı konularak valproik asit tedavisi başlandı. Düzenli psikiyatrik izleme alınan hastanın tedavi başlangıcından üç ay sonraki değerlendirmesinde, davranışsal problemlerde düzelme, konuşma ve sosyal becerilerde belirgin artış gözlendi. Tartışma: Bu makalede OSB belirtileri ile başvuruda bulunan ve LKS tanısı konan bir çocukta antiepileptik tedavi ile otizm belirtilerinde hızlı düzelme bildirilmiştir. Bu vakada antiepileptik ilaç kullanımı ile ortaya çıkan konuşmanın yeniden kazanılması ve sosyal becerilerdeki hızlı düzelme kayda değer bir bulgudur. Erken tanı konması ve uygun antiepileptik tedavi ile burada sunulan olguda olduğu gibi yüz güldürücü sonuçlar elde edilebilir.
Antiepileptic Treatment in a Child With Landau Kleffner Syndrome: A Case Report
Introduction: Landau-Kleffner Syndrome is a rare childhood disorder characterized by acquired aphasia and epileptiform EEG abnormalities. Hyperactivity and attention problems are common in LKS, and symptoms of Autism Spectrum Disorders (ASDs) may also coexist. Many different treatments have been used for LKS, with varying rates of success. In particular, the effects of antiepileptic drug treatment on acquisition of language have been inconsistent. To the best of our knowledge the literature does not include any reports on the effect of antiepileptic drug treatment on ASD symptoms in patients with LKS. Herein we report a boy with LKS whose ASD symptoms markedly improved in response to antiepileptic treatment. Case: A boy aged 3 years 10 months presented to the department of child and adolescent psychiatry due to lack of social interaction, decreased eye contact, stereotypic hand movements, and language regression. The patient was diagnosed as LKS and valproic acid (VAL) treatment was started. The patient was followed-up regularly and after 3 months of treatment with VAL substantial improvement was observed in problematic behaviors, and language and social skills. Discussion: In the presented LKS case rapid improvement in autism symptoms was observed in response to antiepileptic drug treatment. The patient’s reacquisition of speech and rapid improvement in social skills with antiepileptic treatment are important findings. It may be possible to effectively treat ASD symptoms in patients with LKS with early diagnosis and appropriate antiepileptic treatment.

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