Desempenho escolar em crianças com epilepsia benigna da infância com pontas centrotemporais

Abstract

RESUMO -Aspectos psicossociais em crianças com epilepsia benigna da infância com pontas centrotemporais (EBICT) são objeto de controvérsias. O objetivo desta pesquisa foi estudar o desempenho escolar em crianças com EBICT. Vinte crianças foram submetidas ao Teste de Desempenho Escolar (TDE) e comparadas a crianças sadias pareadas por idade e escolaridade. Foram estudadas as relações entre o TDE e a lateralidade do foco e o número de descargas ao eletrencefalograma. As crianças com EBICT tiveram, de modo significativo, mais freqüentemente do que as sadias, desempenho inferior no subteste de leitura e no escore total. As crianças com desempenho inferior em leitura apresentaram maior número de descargas do que aquelas com desempenho médio e superior. Não houve diferenças no TDE segundo a lateralidade do foco. O número de descargas, ao interferir com a função cerebral, pode ser um fator a explicar o desempenho mais baixo na leitura.PALAVRAS-CHAVE: epilepsia idiopática, eletrencefalograma, atividade epileptiforme, leitura. School performance in children with benign childhood epilepsy with centrotemporal spikesABSTRACT -Neuropsychological implications of benign childhood epilepsy with centrotemporal spikesrolandic spikes (BECTS) have not been adequately investigated.The aim of this study was to compare the results in a school performance test of patients with BECTS and normal age-matched controls.A total of 20 children with BECTS and 20 normal controls were submitted to anamnesis, clinical evaluation, Raven test, school performance test (SPT), digital electroencephalogram and quantitative electroencephalogram analysis. Comparing with normal controls, children with BECTS showed significantly lower SPT results, especially in reading test. There was an association between the higher number of rolandic spikes and inferior performance in SPT reading test. These findings suggest that discharges may be a factor in the genesis of lower performance in reading test in children with BECTS.KEY WORDS: rolandic epilepsy, electroencephalogram, epileptiform activity, reading, cognition.A epilepsia benigna da infância com pontas centrotemporais (EBICT) é uma forma de epilepsia, a mais comum na infância, para a qual não existem lesões anatômicas demonstráveis e em que há remissão espontânea das crises. O diagnóstico desta síndrome epiléptica é feito face à associação da histó-ria de crises e eletrencefalograma (EEG) sugestivos, na ausência de déficit neurológico ou intelectual [1][2][3] .Vários autores assinalam que as crianças com EBICT não são diferentes das crianças normais em relação a inteligência, desempenho escolar, comportamento e desenvolvimento 4 . Por outro lado, várias pesquisas têm mostrado alterações em testes neuropsicológicos especiais. Piccirilli et al. 5,6 encontraram comprometimento neuropsicológico discreto, sugerindo que as descargas pudessem interferir com o processo de lateralização da linguagem. D`Alessandro et al. 7 descreveram distúrbio no desempenho cognitivo, especialmente nas crianças com descargas no hemis...

Rolandic epilepsy and dyslexia

“…Many studies have addressed the relationship between oral language (especially in relation to praxis) and written language 14,15,16,17,18 . However, these studies did not use the term dyslexia for the abnormalities found in children with BECTS.…”

Benign childhood epilepsy with centro-temporal spikes: correlation between clinical, cognitive and EEG aspects

“…In earlier studies 13 , the SPT instrument was applied to evaluate fundamental abilities in school performance. Frequently and in a statistically significant way, inferior performance was observed in the reading subtest as compared to a control group paired for age and maternal scholastic level.…”

“…Approximately a quarter of the children show some degree of cognitive deficit during the active epilepsy phase 2 . Slight neuropsychological alterations have been described for language [3][4][5][6][7][8][9] , attention 7,10 , executive functions 11 , memory 7,11,12 , visuospatial orientation 4 , phonological processing 12 and school performance 13 . It has been discussed in the literature whether the cognitive deficit occurs due to the location of the EA in the centro-temporal region, side of the CTS, the number of CTS or even to a deficit in brain maturity, which interferes with the functional organization of the developing brain, or if it is due to activity of the focus 3,4,6,8,[14][15][16][17] .…”

Benign childhood epilepsy with centrotemporal spikes: word and pseudoword discrimination

“…However, in the active phase of the epilepsy, discreet deficits may occur in various cognitive functions, with consequent learning difficulties and fall in scholastic performance [1][2][3][4][5][6][7][8] , and reading difficulties are amongst those reported in children with BECTS 7,[9][10][11] . Compromise in the various aspects of language and reading is to be expected due to the superimposition of the cortical areas for language with those of the RS, which concentrate in the lower part of the rolandic area and in the sylvian region, with an eventual extension into the temporal cortex and adjacent parietal region 2,3,12,13 .…”