Neuropsychological disorders related to interictal epileptic discharges during sleep in benign epilepsy of childhood with centrotemporal or Rolandic spikes

Abstract

Nine children (five males, four females; age range 6 years 1 month to 11 years 1 month) affected by benign epilepsy of childhood with centrotemporal or Rolandic spikes (BECRS) with EEG evidence of marked activation of interictal epileptic discharges (IEDs) during sleep, and nine unaffected control children matched for age, sex, and socioeconomic status, were enrolled in a prospective study. At the time of detection of IED activation during sleep, patients showed a mean Full-Scale IQ score within the normal range, but significantly below that of control participants; neuropsychological assessment revealed disorders in visuospatial short-term memory (Corsi's Block Tapping Test), attention, and cognitive flexibility (Trail Making Test and Stroop Color-Word Test), picture naming, and fluency (Benton's Naming Test and Word Fluency), visuoperceptual skill (Ghent-Poppelreuter and Street Gestalt Completion Tests) and visuomotor coordination (Bender Test). After detection of IED activation during sleep, children were followed up for 2 years. At the time of IED remission (T1), neuropsychological re-evaluation showed a notable increase in IQ score and a significant improvement (t-test: p<0.007) in visuomotor coordination, non-verbal short-term memory, sustained attention and mental flexibility, picture naming, and visual-perceptual performance. At T1, patients' performance did not differ from the controls (Mann-Whitney U test).

Do sequential EEG changes predict atypical clinical features in rolandic epilepsy?

“…In contrast, several studies have shown that neuropsychological functioning improves with normalization of the EEG. 23 Metz-Lutz et al 4 reported that performances in the neuropsychological assessments were specifically weakened in individuals with active epilepsy with frequent spike-wave discharges on the waking EEG. These findings suggest that the subclinical discharges contribute to the psychosocial problems that are increasingly recognized in rolandic epilepsy.…”

Academic performance in children with rolandic epilepsy

“…Based on these findings we assumed that epileptic discharges in sleep may interfere with the development of cognitive linguistic processes, if they manifest at a specific age and are long lasting. [11][12][13] As suggested by Aldenkamp and Arends, 14 the presence of an active epileptic focus may interfere with the normal maturation of cognitive functions but its long-term consequences are yet to be determined. In our patients, drug therapy achieved a good seizure control but it was unsatisfactory in reducing nocturnal paroxysmal electric activity.…”

Comorbidity of DCD and SLI: significance of epileptiform activity during sleep

“…The second aim of our study was to search for DCD in children affected by BECTS, a very common idiopathic partial epilepsy in childhood, characterized by excellent prognosis of seizures but not always benign with respect to neuropsychological aspects (Baglietto et al . 2001;Northcott et al .…”

“…Despite the definition of 'Benign' , BECTS is frequently associated with learning disabilities (LD), language impairment, attention deficit or clumsiness (Bouquet et al . 1985;Baglietto et al . 2001;Holtmann et al .…”