Abstracts

Although normal neurological and intellectual developments are expected in benign rolandic epilepsy (BRE), subtle specific interference with language functions were suspected because of the electric discharges are mainly distributed over the centrotemporal regions. Carbamazepine also can cause slowing effect on the motor conduction that induce speech problem.
The aims of this study are to investigate the language and speech problems in BRE with initiation of carbamazepine medication. Eleven patients who met the BRE criteria by ILAE were investigated. We prospectively performed a standardized full language and speech assessment which covered all important aspects of language processing before and after medication of carbamazepine. Computerized Speech Lab used to assess the speech characteristics. Laryngeal articulation pattern, voicing analysis, habitual pitch, voice onset time (VOT) and total duration (TD), vowel formant were compared by acoustic parameters before and after 3 months antiepileptic medications. Laryngeal articulation patterns in all of the patients were the mainly substitutions. The rate of laryngeal articulation error patterns in stop consonants was increased from 12% (12/99) to 26% (26/99) after antiepileptic medication. VOT of stop consonants was not changed after antiepileptic medication. TD of word decreased after medication. Pitch range decreased from 209.9 [plusmn] 29 Hz to 206.2 [plusmn] 38Hz after medication. Energy range in spontaneous speech increased from 17.0 [plusmn] 5 dB to 19.4 [plusmn] 6 dB after antiepileptic medication. Duration of counting (5 to 9) was seen to decrease from 4.2 [plusmn] 1 ms to 3.1 [plusmn] 0.8 ms after medication. Total pitch of counting also decreased from 220.5 [plusmn] 23 Hz to 217.0 [plusmn] 18 Hz after medication. The first (F1) and second (F2) formant of vowels /a, u, o/ decreased after medication. The first formant of vowel /i/ and the second formant of vowel /e/ increased in comparison with before medication. The conclusions of the study as following: 1) The error pattern of laryngeal articulation was exclusively substitution of stop consonants. 2) Habitual pitch and vowel formants (F1 [amp] F2) decreased after antiepileptic medication.
The formant frequency value was lower than normal control group. These finding suggestions those acoustic abnormalities after medication were similar to hypokinetic pattern. This pattern might be influenced by anticholinergic effects of carbamazepine, which decrease nerve conduction velocity and muscle activity. 3) VOT of stop consonants and TD of word were decreased after antiepileptic medication. Further studies are needed to interpretative the meaning of these finding. The results show that the therapeutic use of carbamazepine may induce speech problem. We recommend the logopedic and phoniatric evaluation of speech before/after carbamazepine medication.