Evaluation of a neurotherapy program for a child with ADHD with Benign Partial Epilepsy with Rolandic Spikes (BPERS) using event-related potentials

Abstract

SummaryBackgroundWe hypothesized that there would be a good response to relative beta training, applied to regulate the dynamics of brain function in a patient with benign partial epilepsy with Rolandic Spikes (BPERS), associated with neuropsychiatric deficits resembling the symptoms of attention deficit-hyperactivity disorder (ADHD).Case ReportThe patient, E.Z., age 9.3, was suffering from neuropsychiatric symptoms, cognitive dysfunction, especially attention deficits, and behavioral changes, rendering him unable to function independently in school and in many situations of everyday life. He was treated for epilepsy, but only slight progress was made. The patient took part in 20 sessions of relative beta training combined with behavioral training. We used standardized neuropsychological testing, as well as ERPs before the experiment and after the completion of the neurotherapy program. Neuropsychological testing at baseline showed multiple cognitive deficits. Over the course of neurotherapy, E.Z.’s verbal and non-verbal IQ increased significantly. His cognitive functions also improved, including immediate and delayed logical and visual recall on the WMS-III, maintaining attention on the WMS-III, and executive functions, but remained below norms. Physiologically, the patient showed substantial changes after neurotherapy, including fewer spikes and an increased P300 NOGO component.ConclusionsThe cognitive deficits characteristic for ADHD in a child with BPERS may be unresponsive to antiepileptic treatment, but are reversible after a carefully selected neurotherapy program, combined with antiepileptic treatment. Event Related Potentials (ERPs) in the GO/NOGO task can be used to assess functional brain changes induced by neurotherapeutical programs.

Neuromarkers of anxiety and depression in a patient after neuro-ophthalmic surgery of the meningioma – effect of individually-tailored tDCS and neurofeedback

“…These results mean that the symptoms of post-surgical depression might be treated with the use of the proposed methodology [17]. As proved in another study by the authors [18,19,20], as in this case, the patient was able to returned to work with an improved quality of life.…”

Mapping the Effect of Interictal Epileptic Activity Density During Wakefulness on Brain Functioning in Focal Childhood Epilepsies With Centrotemporal Spikes

“…Nevertheless, over the past years, some investigators have questioned whether BECTS is indeed benign, considering the variety of different presentations associated with the disorder, thus renamed it CECTS instead of BECTS. It is not uncommon for CECTS to be associated with neuropsychological deficits, especially in visuospatial and verbal fluency tests, language (5) and memory (6) and behavioral problems, such as aggressive behavior, social problems, depression, and attention deficits (7)(8)(9). Location of spikes seems to be related to the different selective cognitive deficits in children with CECTS, suggesting an overlap between cortical areas subserving complex cognitive functions and interictal abnormalities sources (10).…”

Children With Epilepsy: Specific Learning Difficulties

“…Moreover, we should have in mind that there is yet another group of children and adolescents in the case of whom there occur both the symptoms of SpLDs and epilepsy, but the latter symptoms have not been diagnosed. This kind of situation can take place in patients with Rolandic epilepsy or with epilepsy with unconsciousness seizures, in the case of whom the period between the occurrence of the first visible epileptic seizures and the diagnosis and introduction of a pharmacological treatment is frequently very long (Pąchalska et al, 2012; Mirski et al, 2012. It is worthy to note that a good response to relative beta training, applied to regulate the dynamics of brain function in a patient with benign partial epilepsy with Rolandic Spikes (BPERS), associated with neuropsychiatric deficits resembling the symptoms of attention deficithyperactivity disorder (ADHD) (see: Pąchalska et al, 2012; Mirski et al, 2012.…”

“…This kind of situation can take place in patients with Rolandic epilepsy or with epilepsy with unconsciousness seizures, in the case of whom the period between the occurrence of the first visible epileptic seizures and the diagnosis and introduction of a pharmacological treatment is frequently very long (Pąchalska et al, 2012; Mirski et al, 2012. It is worthy to note that a good response to relative beta training, applied to regulate the dynamics of brain function in a patient with benign partial epilepsy with Rolandic Spikes (BPERS), associated with neuropsychiatric deficits resembling the symptoms of attention deficithyperactivity disorder (ADHD) (see: Pąchalska et al, 2012; Mirski et al, 2012. Although epilepsy is undoubtedly a neurological disease, we should ask whether every diagnosis of epilepsy in a child really means discovering a sole factor, listed in the ICD-10 classification, that is responsible for the appearance of, for instance, difficulties in learning how to read, and which, at the same time, makes it impossible to diagnose, for example, developmental dyslexia?…”