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Kinder- und Jugendmedizin 2003; 03(02): 59-63
DOI: 10.1055/s-0037-1617777
Epilepsie
Schattauer GmbH

Einfluss interiktaler EEG-Entladungen auf die Kognition

Klinisches Spektrum und therapeutische OptionenInfluence of interictal discharges on cognitionClinic and therapeutic considerations
Christian Mühe
1   Kinderklinik und Kinderpoliklinik im Dr. v. Haunerschen Kinderspital der LMU München (Direktor: Prof. Dr. med. D. Reinhardt)
,
Andreas Merkenschlager
2   Universitätsklinik und Poliklinik für Kinder und Jugendliche Leipzig (Direktor: Prof. Dr. med. W. Kiess)
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
11. Januar 2018 (online)

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Zsuammenfassung

Interiktale epilepsietypische Potenziale werden als eine der möglichen Gründe für die häufiger ungünstige kognitive Performance von Kindern mit Epilepsie diskutiert. Es werden dabei punktuelle kognitive Defizite, TCI (»transitory cognitive impairment«), von längerfristigen Störungen unterschieden. Letztere können sich bei der Rolando-Epilepsie z. T. durch Aufmerksamkeitsstörungen und Verhaltensveränderungen zeigen, beim Landau-Kleffner-Syndrom durch eine auditive Agnosie und durch einen globalen kognitiven Abbau beim CSWS (kontinuierliche Spike-wave-Aktivität). Entsprechende pathophysiologische Erklärungsmodelle werden aufgezeigt. Therapieempfehlungen zur EEG-Sanierung bestehen beim Landau-Kleffner-Syndrom und CSWS, Therapieversuche zur EEG-Behandlung anfallsfreier Kinder mit weniger auffälligen kognitiven Einbußen zeigen uneinheitliche Ergebnisse. Diese bedürfen derzeit einer Einzelfallentscheidung mit sorgfältiger Dokumentation.

Summary

Interictal epileptiform discharges might be one of the reasons for cognitive impairment of children with epilepsy. Acute, momentary cognitive deficit, known as TCI, is distinguished from more prolonged mental disabilities. The latter can be present in Rolando epilepsy as attention deficit and behavioral disturbance, auditory agnosia in Landau-Kleffner syndrome and gobal mental deterioration in CSWS (continuous spike waves during sleep). Pathophysiological considerations are offered. Recommandations for medical treatment in Landau-Kleffner syndrome and CSWS exists, however the results of therapeutic trials in seizure-free children with interictal epileptiform discharges and only moderate cognitive impairment are still contradictory. A decision for treatment requires an individual view of case with sophisticated documentation.

Schlüsselwörter

Interiktale epilepsietypische Potenziale - Kognition - TCI

Keywords

Interictal epileptic discharges - cognition - TCI
 

  • Literatur

  • 1 Aarts JHP, Binnie CD, Smith AM, Wilkins AJ. Selective cognitive impairment during focal and generalised epileptoform EEG activity. Brain 1984; 107: 293-308.
    CrossrefPubMedGoogle Scholar
  • 2 Aldenkamp AP. Effect of seizures and epileptiform discharges on cognitive function. Epilepsia 1997; 38 (Suppl. 01) S52-5.
    PubMedGoogle Scholar
  • 3 Aldenkamp AP, Arends J, Overweg-Plandsoen TCG, van Bronswiik KC, Schyns-Soeterboeck A, v d Linden I Diepman L. Acute cognitive effects of nonconvulsive difficult-to-detect epileptic seizures and epiletiform electrencephalographic discharges. J Child Neurol 2001; 16: 119-23.
    CrossrefPubMedGoogle Scholar
  • 4 Aldenkamp AP, Overweg J, Gutter T, Beun AM, Diepman L, Mulder OG. Effect of epilepsy, seizures and epileptiform EEG discharges on cognitive function. Acta Neurol Scand 1996; 93: 253-9.
    PubMedGoogle Scholar
  • 5 Ambrosetto G, Tassinari CA. Antiepileptic drug treatment of benign childhood epilepsy with rolandic spikes: is it necessary?. Epilepsia 1990; 31: 802-5.
    CrossrefPubMedGoogle Scholar
  • 6 Avoli M. Do interictal discharges promote or control seizures? Experimental evidence from an in vitro model of epileptoform discharge. Epilepsia 2001; 42 (Suppl. 03) 2-4.
    PubMedGoogle Scholar
  • 7 Baglietto MG, Battaglia FM, Tortorelli S, De Negri E, Calevo MG, Veneselli E, De Negri M. Neuropsychological disorders related to interictal epileptic discharges during sleep in benign epilepsy of childhood with centrotemporal or Rolandic spikes. Dev Med Child Neurol 2001; 43: 407-12.
    CrossrefPubMedGoogle Scholar
  • 8 Bailet LL, Turk WR. The impact of childhood epilepsy on neurocognitive and behavioral performance: A prospective longitudinal study. Epilepsia 2000; 41: 426-31.
    CrossrefPubMedGoogle Scholar
  • 9 Baird HW, John ER, Ahn H. Neurometric evaluation of epileptic children who do well and poorly in school. Electroencephalogr Clin Neurophysiol 1980; 48: 683-93.
    CrossrefPubMedGoogle Scholar
  • 10 Bauer J, Wiedemann S, Stefan H. Beeinflussen interiktale generalisierte Spike-wave-Paroxysmen die Aufmerksamkeit von Menschen mit Epilepsie. Z Epileptol 2001; 14: 139-43.
    Google Scholar
  • 11 Berger H. Über das Elektrenkephalogramm des Menschen: Siebente Mitteilung. Arch Psychiatr Nervenkrankh 1933; 100: 301-20.
    CrossrefGoogle Scholar
  • 12 Binnie CD, Marston D. Cognitive correlates of interictal discharges. Epilepsia 1992; 33 (Suppl. 06) S11-7.
    CrossrefPubMedGoogle Scholar
  • 13 Bourgeois BGD, Prensky AL, Plakes HS, Talent BK, Busch SG. Intelligence in epilepsy: a prospectice study in children. Ann Neurol 1983; 14: 438-44.
    CrossrefPubMedGoogle Scholar
  • 14 Brinciotti M, Matricardi M, Paolella A, Porro G, Benedetti P. Neuropsychological correlates of subclinical paroxysmal EEG activity in children with epilepsy. 1: Qualitative features (generalized and focal abnormalities). Funct Neurol 1989; 4: 235-9.
    PubMedGoogle Scholar
  • 15 Deonna T. Acquired epileptiform aphasia in children (Landau-Kleffner syndrome). J Clin Neurophysiol 1991; 8: 288-98.
    CrossrefPubMedGoogle Scholar
  • 16 De Negri M. Electrical status epilepticus during sleep (ESES). Different clinical syndromes: towards a unifying view?. Brain & Dev 1997; 19: 447-51.
    CrossrefGoogle Scholar
  • 17 Dodrill CB. A neuropsychological battery for epilepsy. Epilepsia 1987; 19: 611-23.
    Google Scholar
  • 18 Dodrill CB. Interctal cognitive aspects of epilepsy. Epilepsia 1992; 33 (Suppl. 06) S7-10.
    CrossrefPubMedGoogle Scholar
  • 19 Duvelleroy-Hommet C, Billard C, Lucas B, Gillet P, Barthez MA, Santini JJ, Degiovanni E, Henry F, de Toffel B, Autret A. Sleep EEG and development dysphasia: lack of a consistent relationship with paroxysmal EEG activity during sleep. Neuropediatrics 1995; 26: 14-8.
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 20 Engel AK, König AK, Kreiter TB, Schillen TB, Singer W. Temporal coding in visual cortex: New vistas on integration in the nervous system. Trends Neurosci 1992; 15: 218-26.
    CrossrefPubMedGoogle Scholar
  • 21 Giovagnoli AR, Avanzini G. Learning and memory impairment in patients with temporal lobe epilepsy: relation to the presence, type, and location of brain lesion. Epilepsia 1999; 40: 904-11.
    CrossrefPubMedGoogle Scholar
  • 22 Gokygic A, Caliskan A. Diffus spike-wave status of 9-year duration without behavioural change or intellectual decline. Epielpsia 1995; 36: 210-3.
    Google Scholar
  • 23 Gonzalez-Garrido AA, Oropeza de Alba JL, Gomez-Velazquez FR, Fernandez Harmony T, Soto Mancilla JL, Ceja Moreno H, Perez Rulfo D, Gonzalez Cornejo S, Riestra Castneda R, Aguirre Portillo LE, Gomez Limon E, Ruiz Sandoval JL. Transitory cognitive impairment in epileptic children during a CPT task. Clin Electroencephalograpr 2000; 31: 174-80.
    Google Scholar
  • 24 Gordon N. Acquired aphasia in childhood: the Landau-Kleffner syndrome. Dev Med Child Neurol 1990; 32: 270-74.
    Google Scholar
  • 25 Homan RW, Paulman RG, Devous MD, Wacker P, Jennings LW, Bonte FJ. Cognitive function and regional cerebral blood flow in partial seizures. Arch Neurol 1989; 46: 964-70.
    CrossrefPubMedGoogle Scholar
  • 26 Hopfield JJ. Pattern recognition computation using action potential timing for stimulus representation. Nature 1995; 376: 33-6.
    CrossrefPubMedGoogle Scholar
  • 27 Kasteleijn-Nolst Trenité DGA, Bakker Dj, Binnie CD, Buerman A, van Raaij M. Psychological effects of epileptoform EEG discharges. I: Scholsatic skills. Epilepsy Res 1988; 2: 111-6.
    CrossrefPubMedGoogle Scholar
  • 28 Kasteleijn-Nolst Trenité DGA, Riemersma JBJ, Binnie CD, Smit AM, Meinardi H. The influence of subclinical epileptiform EEG discharges on driving behaviour. Electroencephalogr Clin Neurophysiol 1987; 67: 167-70.
    CrossrefPubMedGoogle Scholar
  • 29 Kasteleijn-Nolst Trenité DGA, Siebelink BM, Berends SGC, van Strien JW, Meinardi H. Lateralized effects of subclinical epileptiform EEG discharges on scholastic performance in children. Epilepsia 1990; 31: 740-6.
    CrossrefPubMedGoogle Scholar
  • 30 Krakow K, Baxendale SA, Maguire EA, Krishnamoorthy ES, Lemieux L, Scott CA, Smith SJ. Fixation-off sensitivity as a model of continous epileptofirm discharges: electroencephalographic, neuropsychological and functional MRI findings. Epilepsy Res 2000; 42: 1-6.
    CrossrefPubMedGoogle Scholar
  • 31 Maquet P, Hirsch E, Metz-Lutz MN, Motte J, Dive D, Mavescaux C, Franck G. Regional cerebral glucose metabolism in children with deterioration of one or more cognitive functions and continous spike-wave discharges during sleep. Brain 1995; 118: 1497-520.
    CrossrefPubMedGoogle Scholar
  • 32 Marston D, Besag F, Binnie CD, Fowler M. Effects of transitory cognitive impairment on psychosocial functioning of children with epilepsy: a therapeutic trial. Dev Med Child Neurol 1993; 35: 574-81.
    Google Scholar
  • 33 Medvedev AV. Epileptiform spikes desynchronize and diminish fast (gamma) activity of the brain. An “anti-binding”-mechanism. Brain Res Bull 2002; 58: 115-28.
    CrossrefPubMedGoogle Scholar
  • 34 Perez R, Davidoff V, Despland PA, Deonna T. Mental and behavioural deterioration of children with epilepsy and CSWS: acquired epileptic frontal syndrome. Dev Med Child Neurol 1993; 35: 661-74.
    Google Scholar
  • 35 Pullianinen V, Kikka P, Jokelainen M. Motor and cognitive functions in newly diagnosed adult seizure patients before antiepileptic medication. Acta Neurol Scand 2000; 101: 73-8.
    PubMedGoogle Scholar
  • 36 Rugland AL. “Subclinical” epileptogenic activity. In: Sillanpää M, Dam M, Blennow G. (ed). Pediatric epilepsy. Petersfield: Wrightson Biomedical Publishing; 1990: 217-24.
    Google Scholar
  • 37 Ronen GM, Richards JE, Cunningham C, Secord M, Rosenbloom D. Can sodium valproate improve learning in children with epileptiform bursts but without clinical seizures?. Dev Med Child Neurol 2000; 42: 751-5.
    CrossrefPubMedGoogle Scholar
  • 38 Schoenfeld J, Seidenberger M, Woodard A, Hecox K, Inglese C, Mack K, Hermann B. Neuropsychological and behavioral status of children with complex partial seizures. Dev Med Child Neurol 1999; 41: 724-31.
    CrossrefPubMedGoogle Scholar
  • 39 Schwab RS. A method of measuring consciousness in petit mal epilepsy. J Nerv Ment Dis 1939; 89: 690-1.
    Google Scholar
  • 40 Shewmon DA, Erwin RJ. The effect of focal interictal spikes on perception and reaction time. II. Neuroanatomic specifity. Electrencephalograph Clin Neurophysiol 1988; 69: 338-52.
    Google Scholar