By: Fiza Nadeem
Epilepsy, Language Development, and Tuberous Sclerosis Complex (TSC)
Epilepsy is a neurological disorder which features unwarranted seizures that range in how severe they are (Kluger et al., 2021). Epilepsy affects approximately 65 million people worldwide, and despite the treatments available, a significant number of patients still suffer from recurrent seizures, which can involve social stigma and risk of death (Sirven, 2015).
Language development involves understanding, applying, and acquiring knowledge regarding grammatical aspects in order to communicate with other individuals. It involves encoding and decoding information, understanding grammatical rules, and syntax.
Tuberous sclerosis complex (TSC) is a genetic disease that is acquired through a mutation of the TSC1 and TSC2 genes (Gipson et al., 2023). It causes non-cancerous tumors and lesions to grow in different areas of the body, such as the eyes, heart, lungs, kidneys, skin, and in the brain (Roberds & TSC Alliance, n.d.). The lesions are areas where there is brain damage to the tissues. Tuberous sclerosis complex (TSC) includes lesions of three types such as subependymal nodules (SEN), subependymal giant-cell astrocytomas (SEGA), and cortical tubers (Roberds & TSC Alliance, n.d.).
Cortical tubers is an area of the brain that is unorganized and consists of abnormal cells (Pounders, 2023). The tubers have a vital role in seizures occurring in individuals with tuberous sclerosis. It is easy to image the cortical tubers in a mature brain by using MRI, as opposed to an infant’s brain. Furthermore, subependymal nodules (SEN) contain small cells which can be found near the cerebral ventricles (Pounders, 2023). The cells are easy to identify using MRI since they consistently accumulate calcium. Lastly, subependymal giant-cell astrocytomas (SEGA) are tumors that are likely to occur in 20% of young children and adolescents (Pounders, 2023).
Tuberous Sclerosis Complex and Epilepsy
Patients who suffer from tuberous sclerosis often encounter delays with language development. For instance, a research study identified that approximately half of the participating individuals with tuberous sclerosis (TSC) and the caregivers of children with neurological disease reported their children having language delays (Gipson et al., 2023). At an early stage, children are able to acquire language very effectively and easily as the language acquisition window remains open. However, when that window is impacted by brain changes due to neurological disorders like tuberous sclerosis complex, it is difficult for children to acquire language abilities. For instance, studies using brain imaging on adults with tuberous sclerosis found that Broca’s area, which is associated with language expression, and Wernicke’s area, which is associated with language comprehension, activate at the same time instead of in sequence (Gipson et al., 2023). As a result, the Broca and Wernicke areas are activated at the same time, in return, making it difficult to understand language.
Moreover, epilepsy is associated with language development as it causes disruption. This is due to the antiseizure medications which children are prescribed to take. The medicine is associated with the receptive vocabulary size and gestures at 8–18 months, and with their expressive vocabulary at 8–18 months (Gipson et al., 2023). As a result of the medicine impacting their language ability, the children had smaller vocabularies (Gipson et al., 2023). Furthermore, the impact on children’s vocabulary has an association with how long the seizures are and the reactions to medicine, as children who have a large expressive vocabulary tend to have shorter durations of seizures (Gipson et al., 2023).
Conclusion
In conclusion, epilepsy and tuberous sclerosis are neurological conditions that can significantly impact cognitive, language, and emotional development. Neurological disorders are evidence of how different regions of the brain are impacted, which have an impact on an individual through language, behavioural, and emotional difficulties.
References:
Gipson, T. T., Oller, D. K., Messinger, D. S., & Perry, L. K. (2023). Understanding speech and language in tuberous sclerosis complex. Frontiers in Human Neuroscience, 17, 1149071. https://doi.org/10.3389/fnhum.2023.1149071
Pounders, A., & TSC Alliance (2023, November). Brain abnormalities – TSC Alliance. TSC Alliance. https://www.tscalliance.org/understanding-tsc/clinical-manifestations/brain-neurologi cal-function/brain-abnormalities/
Roberds, S., & TSC Alliance . (n.d.). Tuberous Sclerosis Complex. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/disorders/tuberous-sclerosis-complex
Sirven, J. I. (2015). Epilepsy: A Spectrum Disorder. Cold Spring Harbor Perspectives in Medicine, 5(9), a022848. https://doi.org/10.1101/cshperspect.a022848
