To sleep, perchance to speak

Abstract

Few disorders provoke such intense anxiety and fear among parents as does isolated language regression and language regression with autistic regression among young children. The possible increase in prevalence of autism in the United States1 has helped focus attention on our inability to treat or prevent autism.2 Case series describing improved language function after treatment of Landau-Kleffner syndrome (LKS) and electrographic status epilepticus in sleep (ESES)3,4 have been a source of hope for parents of children with language regression and normal hearing, but no treatment has been proven effective in improving language function. Child neurologists and developmental pediatricians often perform all-night sleep recordings on children with language regression hoping to find this devastating, yet theoretically treatable, condition. Experts have debated whether these language regression disorders represent a spectrum of phenotypes with common features that allow them to be grouped together for clinical studies, or whether they are distinct phenotypic syndromes that should be considered separately.5,6 In this issue of Neurology, …