Cerebral dominance in an unusual case of Landau-Kleffner syndrome

Landau-Kleffner syndrome (LKS) is described by the International Classification of Epileptic Syndromes since 1985 as a constellation of clinical and electrographic signs, including acquired aphasia, regression of language milestones and seizures, along with sleep-activated paroxysms on electroencephalogram which can progress to electrographic status epilepticus of sleep. In this case, a 7-year-old boy presented with an atypical history of new-onset aphasia and regression of language milestones with rare seizures. However, there was an electrographic mismatch in the form of right-sided epileptiform activity and continuous spike and wave of sleep pattern. Detailed speech analysis and perusal of the history revealed a possibly ambidextrous child with right hemispheric language dominance, and he was diagnosed with LKS and treated. This report illustrates the many pitfalls in the diagnosis and treatment of this rare epileptic syndrome.

Are Footedness and Lateral Postures Better Predictors of Hemispheric Dominance Than Handedness: A Cross-sectional Questionnaire-Based Clinical and Pedigree Study

Objective Approximately 9 out of 10 individuals show right-hand dominance. The remaining 10% include left-hand dominant and mixed handed/ambidextrous individuals. Laterality, lateral postures or lateral preference is defined by various authors as the most comfortable posture that an individual prefers to assume. The current study aims at finding the distribution of these lateral postures and their correlation with handedness/dominant side. Materials and Methods The study was done in medical and nursing students in the age group 18 to 22 years. The patients were asked to fill a self-assessment questionnaire to determine handedness and footedness. The laterality traits were observed by asking the patients to do by themselves after an untailored demonstration. Statistical Analysis The relationship between study parameters was assessed using Chi-square test. Pearson’s correlation test was done to assess the strength of association between comfort ratings of the various laterality postures. Results In our study, 96.5% were right handed and 79.9% of patients were right footed. Also, 50.8% preferred right-hand clasping, 53.9% preferred left-arm folding, and 60.6% preferred right-leg folding. A statistically significant correlation was seen between foot preference and lateral postures and arm folding and hand clasping (p < 0.05). A significant association was also found between handedness and positive history of retraining. Sidedness did not follow any Mendelian pattern of inheritance. Conclusions Handedness is affected by genetic and environmental factors. Since cultural and traditional practices can affect the lateral postures and handedness, it is important to know the relationship between laterality postures and sidedness and the impact of retraining on them. These postures are measures of cerebral dominance and are clinically important.

SCOPE OF SPEECH LANGUAGE THERAPY

The consistent indulgence of the developed world in neurological research, during the post second world war era, led to several discoveries and subsequently the laying down of several theories about socio-communicative behaviors in human beings. The areas of the brain responsible for the functions of speech and language were studied further, providing an insight to the role of the brain in cognitive skills of attention, recall, memory, analytical and inferential skills, as well as judgment, necessary during verbal and nonverbal communication. Information about cerebral dominance for language, which lies in the left hemisphere for a larger majority of people; led to establishing the role of the right hemisphere for the supra-segmental features of language, or the meaning of spoken utterances carried by the rhythm in our speech. Thus ‘aphasiology’ emerged as the ‘study of aphasia’ which is an acquired language disorder that results from an insult to the brain, mostly in adults who have used language in the best possible way through their lives; but may also be seen in children known as ‘childhood aphasia.’ The period and pattern of recovery from aphasia varied greatly in adults and children, which led to establishing the theory of ‘critical period’ for language development, shedding more light on the miraculous development and functioning of the human neurological system since birth, for language. Knowledge about the rapid development of the human brain in the early years of life led to the essential concept of ‘early intervention’ of children having any communicative or physical challenges

The relation between cerebral dominance and visual analytic skills in Iraqi medical students, a cross sectional analysis

Background: Cerebral dominance, also known as lateralization of brain functions, is the neurologic phenomenon in which one hemisphere is dominant over the other, and will thereby exercise greater influence over certain functions. The cerebral lateralization of many vertebrates, indicates an evolutionary advantage associated with the cerebral specialization. In humans, the majority of people are of left cerebral dominance. True bilateral cerebral dominance, manifested in ambidexterity, is exceedingly rare.Aims and Objective: To derive a statistical inference between determined parameters of cerebral dominance and the 3-dimensional visual analytic skills. The parameters are: handedness, , gender, and language skills.Materials and Methods: This survey targeted an audience of undergraduate medical students, 103 of them replied and fully completed an electronic-distributed survey. All participants were blinded to the outcome and aims of the study (single-blinded experimental design). The survey was created via Google Forms, and made available online for three days, on the University intranet system. Compiled data resulted in 523 pages. Statistical analyses were conducted using the Statistical Package for Social Sciences, Shodor-Interactivate software, and Microsoft Excel 2016. References of this paper, were retrieved via a detailed systematic review of literature databases, while carrying out critical evaluation of evidence. The databases included: PubMed, The Cochrane Library, Scopus, OpenGrey, and Google Scholar.Results: Males and females participated in the survey (34 and 69 participants respectively), 91 of participants (88.4%) were right-handed. Mapped participants’ demographics included: age, gender, handedness, siblings’ and parents’ handedness, number of siblings and birth order, and number of spoken languages. The 3D-visual analytic skills, were evaluated via a cross sectional survey and objectively-evaluated via a professional visual IQ testing. Statistics proven that there was no significant correlation between the 3D-visual skills and any of the tested parameters. Significance was considered at a p-value of 0.05 or less.Conclusion: In this sample of 103 tested subjects, all of which were not professional Anatomists. Our tested hypothesis of the presence of potential correlation between handedness (and other parameters of cerebral dominance) with the three-dimensional visual analytic skills, were proven statistically to be non-existent. Asian Journal of Medical Sciences Vol.7(5) 2016 47-52