The effect of benign epileptiform discharges of childhood on cognitive function, behavior and speech

Abstract

The article presents a case report, and a literature review on benign epileptiform discharges of childhood (BEDC) as well as effect of this type of epileptiform activity on speech, behavior and communication skills are analyzed. The incidence of BEDC comprises 5% in pediatric population. Examining children with autistic spectrum disorder, BEDC is revealed in 20% cases, whereas in those with attention deficit and hyperactivity disorder (ADHD) or speech disorder – in 25% and 18% cases, respectively. Many studies considering BEDC as a genetic marker of brain immaturity highlighted by different level of expressiveness and penetrance are discussed. It is highly probable that cognitive and speech disorders as well as ADHD in children with BEDC may be genetically determined. However, pediatric BEDC may be asymptomatic or become manifested by diverse psychoneurological symptoms accounted for by developed epileptic encephalopathy and continuous spike and waves during slow wave sleep (CSWS) requiring specialized long-term treatment. Markedly elevated CSWS with morphological BEDC affects interneuron connections, which, in turn, alters memory consolidation in mesial temporal regions. The literature analysis revealed that children with BEDC-like epileptic activity require obligatory periodic sleep electroencephalographic control and dynamic neuropsychological evaluation due to high incidence of speech, mnestic and behavioral disorders. Seizure-free BEDC-like epileptic activity should be corrected pharmaceutically only in case of established causative link with progressive cognitive impairments.