Acute Cognitive Effects of Nonconvulsive Difficult-to-Detect Epileptic Seizures and Epileptiform Electroencephalographic Discharges

Abstract

This study compares the acute cognitive effects of short nonconvulsive seizures with the effects of interictal epileptiform electroencephalographic (EEG) discharges in children. The study is a prospective, standardized, nonrandomized, and open clinical comparative study. Eligible patients were included when they had (a) unclear seizures and fluctuations in cognitive performance and (b) frequent epileptiform EEG discharges in a recent EEG. All children were assessed with EEG/video (Brainlab) simultaneously with computerized neuropsychologic testing (FePsy) assessing motor speed/alertness, mental speed/attention, and memory function. Eleven patients with short nonconvulsive seizures during cognitive testing were included and compared with 11 matched patients with interictal epileptiform EEG discharges during cognitive testing but without seizures. Patients included in both groups had a reconfirmed diagnosis of epilepsy. Cognitive performance for both groups was compared. Statistical analysis showed significant correlations between the number of seizures (during cognitive testing) and impaired alertness and between the duration of the ictal period and memory impairment. Interictal epileptiform EEG discharges do not have an additional independent effect on cognitive function. The results demonstrate the accumulating cognitive effect of seizures and illustrate that frequent seizures, even when these are short in duration and with subtle symptomatology, can have a substantial impact on daily life and can lead to state-dependent learning impairment. Alertness and short-term memory appeared to be the functions that are most vulnerable for the acute effects of seizures.

Early Deficits in Spatial Memory and Theta Rhythm in Experimental Temporal Lobe Epilepsy

“…Alternatively, ILA could have a negative impact when occurring during critical periods, e.g., trace reactivation (Chrobak and Buzsaki, 1994;Csicsvari et al, 2007) or place cell replay (Foster and Wilson, 2006;Molter et al, 2007). In epileptic patients, IA, unlike seizures, has no direct effect on cognition (Aldenkamp et al, 2001). However, IA has a small impact during "mechanistic" cognitive processes, such as attention or mental speed tasks .…”

Psychiatric disorders and behavioral characteristics of pediatric patients with both epilepsy and attention-deficit hyperactivity disorder

“…These include the effects of antiepileptic drugs (AEDs), chronic seizures, and/or non-convulsive epileptiform discharges on vigilance, memory, and processing speed [3][4][5][6][7]. Alternatively, ADHD symptoms may represent a comorbid psychiatric disorder, which is, like epilepsy itself, a manifestation of underlying neurodevelopmental vulnerability [5].…”

Calidad de vida y entorno escolar del niño con epilepsia

“…Es por eso que resulta de vital importancia la actitud que se tome y el modo de educación que se les brinde a las personas menores de edad con esta enfermedad, pues el deterioro de las habilidades intelectuales y psicosociales en la etapa de la niñez es proporcional a la frecuencia de las crisis epilépticas y la duración de la enfermedad (Aldenkamp et al, 2001), lo que puede traer como consecuencias que se entorpezca el proceso de desarrollo de su personalidad y crezcan siendo seres humanos llenos de prejuicios, dependientes a causa de la sobreprotección de la que forman parte, solitarios debido al rechazo social de que son objeto en la escuela y por sobre todo para que se integren satisfactoriamente y sin conflictos en la sociedad a la cual pertenecen y de la cual dependen.…”