Unraveling the Overlap Between Landau-Kleffner Syndrome and Autism Spectrum Disorder: A Systematic Review and Case Series
Abstract number :
3.441
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2025
Submission ID :
1433
Source :
www.aesnet.org
Presentation date :
12/8/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Samali Wijetunga, BS – Children's Healthcare of Atlanta, Emory University
Amber Allen, BS – Children's Healthcare of Atlanta, Emory University
Ivana Cernokova, PhD – University of North Texas
Christen Holder, PhD – Le Bonheur Children's Hospital/University of Tennessee Health Science Center College of Medicine
Sarah Weatherspoon, MD – Le Bonheur Children's Hospital/University of Tennessee Health Science Center College of Medicine
Donald Bearden, PhD, ABPP-CN – University of Tennessee Health Science Center and Le Bonheur Children's Hospital
Rationale: Landau-Kleffner Syndrome (LKS) and autism spectrum disorder (ASD) are distinct neurodevelopmental conditions that can present with overlapping features such as language regression, behavioral disturbances, and social withdrawal. These similarities often complicate differential diagnosis, especially in early childhood. Accurate distinction is critical for appropriate intervention and prognosis. This study aims to clarify diagnostic boundaries and explore potential comorbidity between LKS and ASD through a systematic review and case series.
Methods: A PRISMA-guided systematic review was conducted, identifying 23 studies for qualitative synthesis. Additionally, retrospective data from eight pediatric patients were analyzed, incorporating clinical, neurophysiological, and behavioral information. Case vignettes were developed to illustrate diagnostic trajectories and highlight distinguishing features. EEG findings, language regression patterns, and core ASD traits were examined across cases. Parent-reported ASD symptoms were compared with in-office assessments to evaluate diagnostic consistency.
Results: Key differentiators between LKS and ASD included the timing and nature of language regression, specificity of EEG abnormalities, and presence of core ASD traits such as restricted interests and deficits in social reciprocity. LKS typically involved acquired aphasia and epileptiform EEG abnormalities, often during sleep, while ASD was marked by early-emerging social communication deficits, with or without seizures or EEG anomalies. Four cases demonstrated a progression from LKS to ASD, showing initial EEG abnormalities and language regression followed by persistent social deficits and restricted behaviors. Other cases retained classic LKS features without ASD traits. Two cases exhibited profound ASD-consistent impairments without EEG-confirmed ESES. Discrepancies were noted between parent ratings and clinical ASD assessments in multiple cases.
Conclusions: This study underscores the diagnostic complexity in distinguishing LKS from ASD and highlights the potential for comorbidity. A diagnostic decision tree is proposed to aid clinicians in identifying ASD in children with a history of LKS. Findings support the need for multidisciplinary evaluation and ongoing monitoring in children presenting with language regression and behavioral changes. Enhanced diagnostic clarity may facilitate earlier, more targeted interventions and improve long-term outcomes.
Funding: No funding supported this study.
Clinical Epilepsy