Cognitive effects of interictal epileptiform discharges in children
Cognitive effects of interictal epileptiform discharges in children
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DOI：
10.1016/j.ejpn.2012.05.010
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发表时间：
2012-11-01
影响因子：
3.1
通讯作者：
Aldenkamp, B.
中科院分区：
文献类型：
--
作者：
Ebus, S.;Arends, J.;Aldenkamp, B.
频繁的间断性癫痫样放电（ied）可能对认知有影响。我们分析了182名患有不同癫痫综合征的儿童，他们都有ied，但没有观察到癫痫发作，并进行了24小时动态脑电图和认知测试。在清醒和睡眠状态下，IED指数以占时间的百分比分为五类（0%,= 10-50%和>= 50%）。简易爆炸装置被定义为尖峰或尖峰波复合体，孤立或连续（连续）发生，没有明显的癫痫发作的临床症状。IED类别与认知测试结果和癫痫特征相关。在>= 10%的脑电图记录中，每日发生ied的患者表现为中枢信息处理速度、短期言语记忆和视觉运动整合受损。这种效果独立于其他脑电图相关和癫痫相关特征，独立于癫痫综合征诊断。夜间简易爆炸装置的影响不那么重要；只是部分导致中央信息处理速度变慢。我们的结论是，在清醒的脑电图中频繁的ied（超过记录的10%）会损害儿童的认知表现。高日尖峰频率和低发作频率的儿童是否可以从抗癫痫治疗中获益，应在对照试验中进行检验。(C) 2012年欧洲儿科神经病学学会。Elsevier Ltd.出版。版权所有。
Frequent interictal epileptiform discharges (IEDs) may have effects on cognition. We analysed a group of 182 children with different epilepsy syndromes, all of whom had IEDs that did not result in observed seizures, with 24-h ambulatory EEG and cognitive tests. The IED index was estimated, in wakefulness and in sleep, as percentage of time in five categories (0%, = 10-50% and >= 50%). IEDs were defined as spikes or spike-wave complexes, isolated or occurring serially (in runs) without evident clinical signs of a seizure. The IED categories were correlated to cognitive test results and epilepsy characteristics. The group of patients with diurnal IEDs in >= 10% of the EEG record showed impaired central information processing speed, short-term verbal memory and visual-motor integration. This effect was seen independently from other EEG-related and epilepsy-related characteristics, and independently from epilepsy syndrome diagnosis. The impact of the nocturnal IEDs was of less importance; only contributing partially to the slowing of central information processing speed. We conclude that frequent IEDs (in more than 10% of the record) in the awake EEG can impair cognitive performance in children. Whether children with a high diurnal spike frequency and low seizure frequency can benefit from antiepileptic treatment should be examined in controlled trials. (C) 2012 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.