Commentary

A number of severe epileptic conditions, such as some frontal lobe epilepsies with subcontinuous specific EEG activity (including rapid activity lasting for 1-1.5 seconds) are associated with severe behavioural disturbances (sometimes with psychotic symptoms) or schizophrenia-like or autism-like syndromes. The literature also includes cases of selective cognitive disturbances associated with EEG anomalies, such as the Landau-Kleffner syndrome. There are also other cases in which an early disturbance of language function has led to a disturbance in communication and social interaction, such as the cases reported by Echenne et al.,1 which others have included among the regressive autistic syndromes with epileptiform anomalies.2 There are also extreme conditions involving severe and complex impairment of mental functions, such as the continuous spike-wave during sleep syndrome, in which cognitive deterioration (with deficits in attention, memory, problem solving, abstraction and learning) is associated with a behavioural and psychiatric disturbance characterized by hyperkinesia, impulsiveness, perseveration, personality alteration with autistic regression, and disintegrative psychosis. Roulet-Perez et al.3 and Patry et al.4 have proposed the hypothesis of an acquired epileptic frontal syndrome in these cases.