FC43.4 Transient cognitive impairment (TCI) in children with benign childhood epilepsy with centrotemporal spikes

Fonseca, Lineu Corrêa; Ximenes, V.

doi:10.1016/j.clinph.2006.06.143

Cited by 3 publications

(6 citation statements)

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“…A possible mechanism for transitory cognitive difficulty during CTS in the genesis of cognitive difficulties and behaviour, has surprisingly been little assessed in the literature 23 and, in recent research, only 15% of the children showed alterations, and even this was limited 29,30 .…”

Section: Discussionmentioning

confidence: 99%

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

Fonseca

Tedrus²,

Pacheco

et al. 2007

Arq. Neuro-Psiquiatr.

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-Benign childhood epilepsy with centro-temporal spikes (BECTS) is a form of epilepsy with no demonstrable anatomical lesion showing spontaneous seizure remission. During the active phase of the disease the children may show cognitive deficits. The objective of this study was to assess, in children with BECTS, the relationship between clinical-EEG aspects and performance in the school performance test (SPT), Raven's progressive matrixes test and the Wechsler Intelligence Scale for Children (WISC-III). Forty-two 7 to 11 year old children were included and the following tests carried out: anamnesis, neurological examination, electroencephalogram (EEG), SPT, Raven's test and WISC-III. The children with BECTS had normal IQ values but showed inferior performance in the SPT more frequently than "healthy" children, paired with respect to age and maternal scholastic level. There was moderate positive correlation between WISC-III results and the age when the seizures started and the educational level of the parents. On the other hand, aspects linked to the epileptic nature of BECTS, such as the number of seizures, time since last seizure and the number and lateralization of the centro-temporal spikes on the EEG, showed no correlation with the neuropsychological tests.KEy WORDS: benign childhood epilepsy, epileptiform activity, electroencephalogram, cognition.Epilepsia benigna da infância com pontas centrotemporais: correlação entre aspectos clínicos, eletrencefalográficos e cognitivos RESUMO -A epilepsia benigna da infância com pontas centrotemporais (EBICT) é uma forma de epilepsia na qual não existem lesões anatômicas demonstráveis e há remissão espontânea das crises. Na fase ativa da epilepsia as crianças podem apresentar déficits cognitivos. O objetivo deste estudo foi avaliar, em crianças com EBICT, a relação entre aspectos clínico-eletrencefalográficos e o desempenho no teste de desempenho escolar (TDE), no teste das matrizes progressivas de Raven e na Escala Wechsler de Inteligência para Crianças (WISC-III). Foram incluídas 42 crianças de 7 a 11 anos de idade. Foram realizados: anamnese, exame neurológico, eletrencefalograma (EEG), TDE, teste de Raven e WISC-III. As crianças com EBICT tiveram valores normais de QI e apresentaram desempenho inferior no TDE mais freqüentemente que crianças "sadias" pareadas quanto à idade e à escolaridade materna. Houve correlação positiva moderada entre idade de início das crises e escolaridade dos pais com resultados do WISC-III. Por outro lado, aspectos ligados à natureza epiléptica da EBICT como número de crises, tempo decorrido da última crise, número e lateralidade das pontas centrotemporais ao EEG não mostraram correlação com os resultados dos testes neuropsicológicos.PAlAvRAS-CHAvE: epilepsia focal benigna, atividade epileptiforme, eletrencefalograma, cognição.

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Section: Discussionmentioning

confidence: 99%

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

Fonseca

Tedrus²,

Pacheco

et al. 2007

Arq. Neuro-Psiquiatr.

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“…Most previously published studies on awake EEG analyses have focused on ECTS with the objectives to compare patients with and without cognitive impairment (15,16,18) or to predict which patients will evolve to EE-CSWS in performing longitudinal EEG studies (19,20). In a retrospective study comparing six ECTS patients with educational impairments to 20 ECTS patients with a typical academic level, Nicolai et al found that the presence of intermittent slow-wave focus during wakefulness was associated with educational impairments [15].…”

Section: Discussionmentioning

confidence: 99%

“…These investigations are more difficult to organise, more time-consuming and more expensive to carry out than an awake EEG. Although studies on awake EEGs have shown that intermittent slow-wave focus [15], a higher daytime spike frequency [16][17][18] and spreading of focal discharges to adjacent regions and/or the other hemisphere were more frequent in EE-CSWS compared with typical SFE at the time of cognitive worsening [19], so far no study has specifically looked at whether awake EEG criteria might be able to differentiate EE-CSWS from typical SFE or which awake EEG criteria have the best inter-rater agreement among readers of different levels of expertise.…”

Section: Introductionmentioning

confidence: 99%

A qualitative awake EEG score for the diagnosis of continuous spike and waves during sleep (CSWS) syndrome in self-limited focal epilepsy (SFE): A case-control study

Aeby

Santalucia

Hecke

et al. 2021

Seizure

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To determine whether awake EEG criteria can differentiate epileptic encephalopathy with continuous spike and waves during sleep (EE-CSWS) at the time of cognitive regression from typical, self-limited focal epilepsy (SFE). Methods: This retrospective case-control study was based on the analysis of awake EEGs and included 15 patients with EE-CSWS and 15 age-matched and sex-matched patients with typical SFE. The EEGs were anonymised and scored by four independent readers. The following qualitative and quantitative EEG indices were analysed: slowwave index (SLWI), spike-wave index (SWI), spike-wave frequency (SWF), long spike-wave clusters (CLSW) and EEG score (between grades 0 and 4). Sensitivity and specificity were assessed using receiver operating characteristic (ROC) curves and their reproducibility with a kappa test. Results: Based on a highly sensitive cut-off, EE-CSWS patients were 8.4 times more likely than those with SFE to have an SLWI > 6%, 15 times more likely to have an SWI > 10 % and six times more likely to have a CLSW of ≥ 1 s. There was substantial agreement between readers (with kappa values of 0.64, 0.69 and 0.67). EE-CSWS patients were 13 times more likely to have an SWF of > 11 % and 149 times more likely to have an EEG score of ≥ 3 than typical SFE patients. Agreement about these ratings was almost perfect (kappa 0.91 and 0.86). Conclusion:An EEG score of ≥ 3 on a 20-min awake EEG differentiates typical SFE from EE-CSWS at the time of cognitive regression, with good reliability across readers with different levels of expertise.

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“…The neuropsychological tests such as Wechsler Intelligence Scale for Children-III (WISC-3rd), verbal fluency test, Wisconsin card sorting test, attention deficit diagnostic scale, and child behavior checklist scale are usually administered to measure a wide range of skills and cognitive functions of RE patients [35][36][37][38]133].…”

Section: Prognosismentioning

confidence: 99%

“…Several studies reported that cognitive abnormalities and behavioral impairments are associated with a high interictal spike frequency [24,25,35,120], the number of interictal abnormalities in wake or sleep [136], activation of interictal spikes during sleep [118,137], and the presence of non-tangential dipole spikes [73].…”

Section: Prognosismentioning

confidence: 99%

Rolandic Epilepsy: Self-Limited Epilepsy with Centrotemporal Spikes

Guliyeva¹,

Tatishvili²,

Kaiyrzhanov³

2021

Epilepsy - Update on Classification, Etiologies, Instrumental Diagnosis and Treatment

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Childhood epilepsy with centrotemporal spikes, had been previously considered as benign childhood epilepsy. According to the new classification proposed by Sheffer I. and colleagues the term “benign” has been changed to “self-limited”. Many studies reported that BECTS may cause transient or long lasting cognitive and behavioral disturbances. Rolandic epilepsy is the most frequent among the childhood focal epilepsy and may account for about 15–25% of all epileptic syndromes diagnosed between the ages of 5 to 15 years. The incidence range changes between 7.1–21 per 100000 in population younger than 15 years with male predominance. The age of onset in 90% of cases between 1 and 10 years with peak around 6–7 years. Seizures mainly occur during a night sleep, whereas the probability of awake seizures are less than 10%. The characteristic clinical features are: (1) focal motor seizure with unilateral orofacial tonic or clonic contractions; (2) speech arrest; (3) hypersalivation; (4) sensory symptoms represented by unilateral numbness or paresthesia of tongue, lips, gum and inner part of the check; (5) unilateral clonic jerk in leg and arm with postictal paresis; (6) generalized seizures. The EEG picture is distinctive in Rolandic epilepsy. The background activity is almost always preserved in awake state and during a sleep. The typical interictal EEG pattern is high voltage, diphasic spikes or sharp waves frequently with slow activity on central-midtemporal region. The centrotemporal spikes or rolandic spikes come from the lower rolandic region created a horizontal dipole with maximal electronegativity in the centrotemporal region and electropositivity in the frontal region usually seen unilateral or bilateral. In most cases children with RE have a good prognosis regarding both seizures and neurodevelopment. The remission of seizures usually occurs before the age of 18 years. The cognitive and behavior problem may happen in active period of disease which are reversable in most of patients.

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FC43.4 Transient cognitive impairment (TCI) in children with benign childhood epilepsy with centrotemporal spikes

Cited by 3 publications

References 0 publications

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

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

A qualitative awake EEG score for the diagnosis of continuous spike and waves during sleep (CSWS) syndrome in self-limited focal epilepsy (SFE): A case-control study

Rolandic Epilepsy: Self-Limited Epilepsy with Centrotemporal Spikes

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