A pediatric opercular-syndrome case showed that language and clinical improvement could occur while substantial sleep-related spike activity remained.
Endpoints changed at different rates
Combined antiseizure treatment including clonazepam did not adequately control the syndrome. After add-on high-dose steroid treatment, clinical features and measured blood-flow fluctuations improved. A high spike-wave index nevertheless persisted in the reported assessment.
Do not reduce response to one signal
The case supports separating seizures, language function, hemodynamics and EEG burden. It does not prove that steroids are superior to clonazepam in a comparable population, because several medicines were involved and only one child was reported. Treatment failure also does not specify which component lacked effect. For a forensic review, the appropriate question is which endpoint improved and when, rather than declaring complete recovery from one encouraging measure or total failure from one persisting abnormality.
Source paper
Original analysis of the supplied journal article, identified as PMC6636014.
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