**9.2 Epileptic aphasia and seizure symptoms and semiology**

LKS appear usually from 2 to 8 years of age; almost 60% of cases have epilepsy as the first symptom, while aphasia in the rest. Aphasia is a verbal auditory agnosia with a subacute onset, followed by rapid reduction of spontaneous speech, with perseverations, paraphasias, phonological errors, and verbal stereotypies; it can progress to mutism. Aphasia frequently has a course with remissions and exacerbations, usually related to quantitative variations of paroxysmal activity during sleeping [2, 96, 97]. The duration of the language disorder is very variable, though if it persists unchanged for more than a year, spontaneous recovery is rare. After a flexible time, aphasia stabilizes and regularly recovers before adulthood [98].

Although between 70 and 80% of patients present with epileptic seizures, these tend to be rare, sometimes a single seizure, which often occurs during sleeping. The seizures present clinical heterogeneity that includes subtle motor events such as ocular flicker, ocular deviation, simple motor focal seizures, AA, unilateral motor seizures, and, eventually, GTCS. CPSs are uncommon, while tonic seizures have never been reported. The course of the epilepsy is typically benign and seizures respond excellent to AED. Seizures eventually disappear over time, generally by about the age of 15 years [98].
