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Poole BJ, Phillips NL, Killer BL, Gilmore C, Lah S. Mathematics Skills in Epilepsy: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2024; 34:598-636. [PMID: 37490196 DOI: 10.1007/s11065-023-09600-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 05/25/2023] [Indexed: 07/26/2023]
Abstract
Mathematics incorporates a broad range of skills, which includes basic early numeracy skills, such as subitizing and basic counting to more advanced secondary skills including mathematics calculation and reasoning. The aim of this review was to undertake a detailed investigation of the severity and pattern of early numeracy and secondary mathematics skills in people with epilepsy. Searches were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Twenty adult studies and 67 child studies were included in this review. Overall, meta-analyses revealed significant moderate impairments across all mathematics outcomes in both adults (g= -0.676), and children (g= -0.593) with epilepsy. Deficits were also observed for specific mathematics outcomes. For adults, impairments were found for mathematics reasoning (g= -0.736). However, two studies found that mathematics calculation was not significantly impaired, and an insufficient number of studies examined early numeracy skills in adults. In children with epilepsy, significant impairments were observed for each mathematics outcome: early numeracy (g= -0.383), calculation (g= -0.762), and reasoning (g= -0.572). The gravity of impairments also differed according to the site of seizure focus for children and adults, suggesting that mathematics outcomes were differentially vulnerable to the location of seizure focus.
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Affiliation(s)
- Belinda J Poole
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - Natalie L Phillips
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - Brittany L Killer
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - Camilla Gilmore
- Centre for Mathematical Cognition, Loughborough University, Loughborough, UK
| | - Suncica Lah
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.
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Halász P, Szũcs A. Self-limited childhood epilepsies are disorders of the perisylvian communication system, carrying the risk of progress to epileptic encephalopathies-Critical review. Front Neurol 2023; 14:1092244. [PMID: 37388546 PMCID: PMC10301767 DOI: 10.3389/fneur.2023.1092244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/04/2023] [Indexed: 07/01/2023] Open
Abstract
"Sleep plasticity is a double-edged sword: a powerful machinery of neural build-up, with a risk to epileptic derailment." We aimed to review the types of self-limited focal epilepsies..."i.e. keep as two separate paragraphs" We aimed to review the types of self-limited focal epilepsies: (1) self-limited focal childhood epilepsy with centrotemporal spikes, (2) atypical Rolandic epilepsy, and (3) electrical status epilepticus in sleep with mental consequences, including Landau-Kleffner-type acquired aphasia, showing their spectral relationship and discussing the debated topics. Our endeavor is to support the system epilepsy concept in this group of epilepsies, using them as models for epileptogenesis in general. The spectral continuity of the involved conditions is evidenced by several features: language impairment, the overarching presence of centrotemporal spikes and ripples (with changing electromorphology across the spectrum), the essential timely and spatial independence of interictal epileptic discharges from seizures, NREM sleep relatedness, and the existence of the intermediate-severity "atypical" forms. These epilepsies might be the consequences of a genetically determined transitory developmental failure, reflected by widespread neuropsychological symptoms originating from the perisylvian network that have distinct time and space relations from secondary epilepsy itself. The involved epilepsies carry the risk of progression to severe, potentially irreversible encephalopathic forms.
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Affiliation(s)
- Péter Halász
- Department of Neurology, University Medical School, Pécs, Hungary
| | - Anna Szũcs
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
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Vetri L, Pepi A, Alesi M, Maltese A, Scifo L, Roccella M, Quatrosi G, Elia M. Poor School Academic Performance and Benign Epilepsy with Centro-Temporal Spikes. Behav Sci (Basel) 2023; 13:bs13020106. [PMID: 36829335 PMCID: PMC9952252 DOI: 10.3390/bs13020106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/05/2023] [Accepted: 01/12/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Poor academic performance of students with epilepsy seems to be a multifactorial problem related to difficulties in reading, writing, math, and logic skills. Poor school and academic performances refer to learning problems in a specific academic area due to learning disorders and learning difficulties not excluding the ability to learn in a different manner during school and academic life. Sometimes, school, academic difficulties, and Rolandic epilepsy can coexist together, and there may be comorbidities. Consequently, the risk of impaired academic performance in people with epilepsy is high. METHODS This review analyzed the relationship between Benign Epilepsy with Centro-Temporal Spikes (BECTS) and poor school and academic performance (PSAP) in children and adolescents (aged 6 to 19), and in adults (aged 20 to no age limit). The PRISMA guideline was used to guide our review strategy. RESULTS This research shows that Benign Epilepsy with Centro-Temporal Spikes (BECTS) and poor school and academic performances are strongly correlated. An early onset age, as well as a long persistence of seizures, correlate more closely with PSAP. On the other hand, it appears that good pharmacological control of seizures and remission from the acute phase of the pathology support better school performance. CONCLUSIONS This review highlights how neuropsychological aspects are also involved in patients with BECTS and PSAP, both in the greater predisposition to the establishment of other neuropsychiatric conditions and in the possibility that stigma conditions and poor academic results may have repercussions on the adaptation and functioning of these subjects. Global management of the subject with BECTS and PSAP is essential, which also pays attention to the aspects of social and scholastic inclusion, both to achieve age-appropriate educational and behavioral objectives, to give the necessary tools for the growth of the individual, and to allow a serene transition to adulthood, favoring autonomous learning and better outcomes.
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Affiliation(s)
- Luigi Vetri
- Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy
- Correspondence: (L.V.); (L.S.)
| | - Annamaria Pepi
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy
| | - Marianna Alesi
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy
| | - Agata Maltese
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy
| | - Lidia Scifo
- Department of Human Studies-Communication, Education and Psychology, LUMSA University, 00193 Roma, Italy
- Correspondence: (L.V.); (L.S.)
| | - Michele Roccella
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy
| | - Giuseppe Quatrosi
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy
| | - Maurizio Elia
- Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy
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Zanaboni MP, Varesio C, Pasca L, Foti A, Totaro M, Celario M, Provenzi L, De Giorgis V. Systematic review of executive functions in children with self-limited epilepsy with centrotemporal spikes. Epilepsy Behav 2021; 123:108254. [PMID: 34428616 DOI: 10.1016/j.yebeh.2021.108254] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 12/01/2022]
Abstract
Self-limited Epilepsy with Centrotemporal Spikes (ECTS) is a self-limiting childhood epilepsy with an overall good prognosis. The neurocognitive profile of ECTS shows various degrees of neuropsychological impairment, with speech impairment and executive dysfunction being the most prominent. This review aimed to clarify the executive function (EF) profile of children with ECTS and the clinical variables' impact on these abilities. We conducted a systematic review of the relevant literature for articles published up to January 2021. Demographic and clinical characteristics were abstracted from the original records. EF tasks used in the studies were classified according to Diamond's model, which identified four components: working memory, inhibitory control, cognitive flexibility, and higher order EFs. Twenty-three studies were included. Among the included records, 14 studies examined working memory, 15 inhibitory control, 15 flexibility, 4 higher order EFs, and 2 general EFs. Results confirmed the presence of a specific impairment in two abilities: inhibitory control and cognitive flexibility. This review confirms the need to assess each EF both in verbal and visual-spatial tasks. The early detection of children with ECTS at risk of developing neuropsychological impairment could activate interventions and prevent worse school achievement, social functioning, and a poor quality of life. Systematic review registration: PROSPERO: CRD42021245959.
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Affiliation(s)
| | - Costanza Varesio
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Ludovica Pasca
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Annalisa Foti
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy
| | - Martina Totaro
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Massimiliano Celario
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Livio Provenzi
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy
| | - Valentina De Giorgis
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy
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Executive Functions and Attention in Childhood Epilepsies: A Neuropsychological Hallmark of Dysfunction? J Int Neuropsychol Soc 2021; 27:673-685. [PMID: 33183389 DOI: 10.1017/s1355617720001125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Patients with epilepsy are at risk for several lifetime problems, in which neuropsychological impairments may represent an impacting factor. We evaluated the neuropsychological functions in children suffering from three main epilepsy categories. Further, we analyzed the longitudinal evolution of the neuropsychological profile over time. METHODS Patients undergoing neuropsychological evaluation at our Department from 2012 to 2018 were identified retrospectively. We selected patients aged 6-16 years and with at least two evaluations. Three epilepsy categories were considered: focal/structural, focal self-limited, and idiopathic generalized. Each evaluation included the same structured assessment of main neuropsychological domains. The effect of the epilepsy category, illness duration, seizure status, and medication was computed in multilevel models. RESULTS We identified 103 patients (focal self-limited = 27; focal/structural = 51; and idiopathic generalized = 25), for 233 evaluations. The majority of deficits were reported in attention and executive functions (>30% of patients); the results were dichotomized to obtain global indexes. Multilevel models showed a trend toward statistical significance of category of epilepsy on the global executive index and of illness duration on global attention index. Illness duration predicted the scores of executive and attention tasks, while category and medication predicted executive task performance. Focal/structural epilepsies mostly affected the executive domain, with deficits persisting over time. By contrast, an ameliorative effect of illness duration for attention was documented in all epilepsies. CONCLUSIONS This study offers lacking information about the evolution of deficits in time, the role of epilepsy category, and possible psychological implications for high-order cognitive skills, central in several social and academic problems.
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Bailey K, McAdam-Wong D, Im-Bolter N. Language measurement in childhood epilepsy: A review. BRAIN AND LANGUAGE 2021; 217:104940. [PMID: 33819772 DOI: 10.1016/j.bandl.2021.104940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
The psychosocial well-being of children and adolescents with epilepsy is affected by comorbid language deficits. Little is known about the focus of current research in language and epilepsy. A systematic review of research was conducted to identify gaps in knowledge regarding language and epilepsy. In total, 83 published articles were eligible for inclusion. More studies included samples presenting with focal seizures (k = 39) compared to generalized seizures (k = 10), few included measures of morphology (k = 4). Most studies (k = 66) included samples of participants across a wide age range. Our review indicated t-hat future research should include a greater focus on participants with more diversity in epilepsy etiology (e.g., symptomatic epilepsy), and seizure type (e.g., generalized seizures), assessment of additional areas of language (e.g., morphology), increased focus on early childhood, focused examination of specific developmental stages, and greater use of comparison groups with an alternate epilepsy diagnosis.
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Affiliation(s)
- Katharine Bailey
- Department of Psychology, Queen's University, Kingston, ON, Canada; Department of Psychology, Trent University, Peterborough, ON, Canada.
| | | | - Nancie Im-Bolter
- Department of Psychology, Trent University, Peterborough, ON, Canada
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Poole BJ, Phillips NL, Stewart E, Harris IM, Lah S. Working Memory in Pediatric Epilepsy: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2021; 31:569-609. [PMID: 33818735 DOI: 10.1007/s11065-021-09491-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 02/21/2021] [Indexed: 10/21/2022]
Abstract
Working memory is a multicomponent system that is supported by overlapping specialized networks in the brain. Baddeley's working memory model includes four components: the phonological loop, visuo-spatial sketchpad, the central executive, and episodic buffer. The aim of this review was to establish the gravity and pattern of working memory deficits in pediatric epilepsy. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guided electronic searches. Sixty-five studies were included in the review. Meta-analyses revealed significant impairments across each working memory component: phonological loop (g = 0.739), visuo-spatial sketchpad (g = 0.521), and central executive (g = 0.560) in children with epilepsy compared to controls. The episodic buffer was not examined. The pattern of impairments, however, differed according to the site and side of seizure focus. This suggests that working memory components are differentially vulnerable to the location of seizure focus in the developing brain.
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Affiliation(s)
- Belinda J Poole
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia
| | - Natalie L Phillips
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia
| | - Elizabeth Stewart
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia
| | - Irina M Harris
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - Suncica Lah
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia. .,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia.
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Malobabić M, Biševac B, Stokanović V. The impact of neuropsychological assessment in epileptic focus localization. PRAXIS MEDICA 2021. [DOI: 10.5937/pramed1902015m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Introduction: Epilepsy that takes place in the temporal lobe is manifested through three symptoms: aura, temporal pseudoabsence and automatisms, while right-sided temporal lobe epilepsy had been also linked with visual or image learning and memory deficits. Case outline: Patient 24 years old in 2020. In July 2020 had complex partial seizures with an unordinary psychomotoric reactions and verbalization, followed by qualitative conscience change in the form of confusion and amnesia. Therapy with paroxetine showed no result. Neuropsychological evaluation showed no other cognitive deficit than severe visuoconstruction dyspraxia and discrete decrease in complex attention. In behavioral aspect prodromal symptoms of tension, anxiety and depression were occurred. Conclusion: Neuropsychological assessment is, along the magnetic resonance imaging and electroencephalographic, the most important method for indicating cognitive deficit in epilepsy and determining the epileptic focus.
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Ross EE, Stoyell SM, Kramer MA, Berg AT, Chu CJ. The natural history of seizures and neuropsychiatric symptoms in childhood epilepsy with centrotemporal spikes (CECTS). Epilepsy Behav 2020; 103:106437. [PMID: 31645314 PMCID: PMC8087164 DOI: 10.1016/j.yebeh.2019.07.038] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/10/2019] [Accepted: 07/12/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Childhood epilepsy with centrotemporal spikes (CECTS) (formally benign epilepsy with centrotemporal spikes, BECTS) is a common childhood epilepsy syndrome characterized by psychiatric, behavioral, and cognitive abnormalities and self-limited seizures. Although CECTS is one of the most well-characterized electroclinical epilepsy syndromes, the natural history of neuropsychiatric outcomes is poorly understood. We report the psychiatric, behavioral, and cognitive profiles over the course of disease from a large, prospectively-enrolled, longitudinal cohort of children with CECTS. We further characterize the detailed seizure course and test the relationship between several proposed risk factors and neuropsychiatric and seizure outcomes in these children. METHODS Patients diagnosed with CECTS were enrolled as part of a community-based study and followed from diagnosis through disease resolution (16.0 ± 3.1 years, N = 60). Twenty sibling controls were also recruited. We report the natural history of premorbid neuropsychiatric concerns, postmorbid neuropsychiatric diagnoses, long-term neuropsychological performance, seizure course, antiseizure medication (ASM) treatment response, and the relationship between duration seizure-free and remission. Age at onset and premorbid neuropsychiatric concerns were tested as predictors of seizure count, epilepsy duration, postmorbid neuropsychiatric diagnoses, and long-term neuropsychological performance. Antiseizure medication treatment duration, seizure count, and epilepsy duration were tested as predictors of postmorbid neuropsychiatric diagnoses and long-term neuropsychological performance. RESULTS Children with CECTS had a high incidence of ADD/ADHD symptoms (18.3%) or learning difficulties (21.7%) before diagnosis. New or persistent ADHD (20%), mood disorders (23.6%), learning difficulties (14.5%), and behavioral disorders (7.3%) were common after CECTS diagnosis. At 9-year follow-up, performance on formal neuropsychological testing was comparable to population statistics and sibling controls. More than two-thirds of treated children experienced at least one seizure during treatment. Most children (61.7%) had entered terminal resolution after 12 months seizure-free. Among all children, for each month seizure-free, there was a 6-7% increase in the probability of achieving terminal remission (p < 1e-10). The presence of a premorbid neurodevelopmental concern predicted a longer epilepsy duration (p = 0.02), higher seizure count (p = 0.02), and a postmorbid psychiatric or neurodevelopmental diagnosis (p = 0.002). None of the tested features predicted long-term neuropsychological performance. SIGNIFICANCE Children are at high risk of neuropsychiatric symptoms along the course of the disease in CECTS, however, long-term cognitive performance is favorable. The majority of children had a seizure while being treated with ASMs, suggesting that CECTS is not as pharmacoresponsive as assumed or that treatment approaches are not optimized. Among treated and untreated children, future seizure-risk can be estimated from duration seizure-free. The presence of a premorbid neuropsychiatric concern predicted a more severe disease course in CECTS.
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Affiliation(s)
- Erin E. Ross
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Sally M. Stoyell
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Mark A. Kramer
- Department of Mathematics and Statistics, Boston University, Boston, MA, USA
| | - Anne T. Berg
- Department of Pediatrics, Epilepsy Center, Ann & Robert H. Lurie Children’s Hospital, Chicago, IL, USA
| | - Catherine J. Chu
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
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The neuropsychological profile of parietal and occipital lobe epilepsy. Epilepsy Behav 2019; 94:137-143. [PMID: 30909077 DOI: 10.1016/j.yebeh.2019.02.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/22/2019] [Accepted: 02/22/2019] [Indexed: 12/20/2022]
Abstract
Despite the extensive body of research in clinical neurology on the functional organization of posterior cortices, parietal and occipital lobe epilepsy (PLE and OLE) have not as yet received the attention afforded frontal and temporal lobe epilepsy (FLE and TLE), perhaps due to their low prevalence. Posterior epilepsies however, represent a challenge for epileptology in general and neuropsychological differential diagnosis in particular. Our main purpose was to examine the likely existence of a pattern of cognitive dysfunction characterizing patients suffering from seizures with a parietal and/or occipital ictal onset. We hypothesized that such patients would present difficulties in the visuospatial and visuoconstructive domains, since spatial analysis and synthesis is an inherent feature of posterior cortical systems. Participants were 14 patients with epilepsy and 14 healthy controls matched for demographic characteristics (gender, age, and education level). We used an extensive battery of neuropsychological tests to assess auditory-verbal memory and learning, episodic memory, attention and working memory, verbal abilities, haptic perception, arithmetic abilities, and executive functions. Special attention was given to visuospatial abilities. Depression and anxiety symptoms were assessed through a self-administered questionnaire. Nonparametric (Mann-Whitney U test) statistical tests were conducted. We found that patients with epilepsy performed significantly worse in visuoconstruction, verbal, and executive functions compared to their healthy matches. Finally, we interpret our findings from the perspective of Luria of mental functions organized into functional systems and the current trends in epileptology to view epilepsy as a system (network) problem.
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Camfield P, Camfield C. Regression in children with epilepsy. Neurosci Biobehav Rev 2019; 96:210-218. [DOI: 10.1016/j.neubiorev.2018.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 11/26/2018] [Accepted: 12/06/2018] [Indexed: 10/27/2022]
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Celiker Uslu S, Yuksel B, Tekin B, Sariahmetoglu H, Atakli D. Cognitive impairment and drug responsiveness in mesial temporal lobe epilepsy. Epilepsy Behav 2019; 90:162-167. [PMID: 30576963 DOI: 10.1016/j.yebeh.2018.10.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 10/17/2018] [Accepted: 10/24/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Mesial temporal lobe epilepsy (MTLE) is the most common form of partial epilepsies. Seizures of MTLE with hippocampal sclerosis (MTLE-HS) are typically resistant to antiepileptic drug (AED) therapy. Although memory disturbances in patients with MTLE-HS are expected, verbal attention and frontal lobe functions may also be impaired. We aimed to examine the relationship between the clinical features and cognitive functions of patients by comparing cognitive test scores of patients with MTLE with few seizures (drug-responsive group) and those with frequent seizures (pharmacoresistant group). METHODS Seventy-nine patients with MTLE-HS and 30 healthy controls were enrolled. Thirty-four patients were accepted as the drug-responsive group (DrG), and 45 patients were included in the pharmacoresistant group (PRG). Tests evaluating attention, memory, and executive functions were performed on all participants. RESULTS Forty-nine (62%) female and 30 (38%) male patients with MTLE-HS, and 14 (46.7%) female and 16 (53.3%) male controls participated in the study. The mean age of the patients and controls was 33.53 ± 9.60 (range, 18-57) years and 35.90 ± 7.98 (range, 18-56) years, respectively. Both the DrG and PRG showed poorer performances in tests evaluating memory and frontal lobe functions when compared with the control group (CG). Additionally, attention test results were significantly worse in the PRG than in the DrG. CONCLUSION It is reasonable to say that increased seizure frequency is the main causative factor of verbal attention deficit due to the poorer attention test results in the PRG. Poor performances in memory and frontal lobe function tests of all patients with MTLE-HS emphasized the importance of the mutual connection between the temporal lobe and prefrontal cortices.
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Affiliation(s)
- Sibel Celiker Uslu
- Samsun Training and Research Hospital Neurology Department, İlkadım, 55090 Samsun, Turkey
| | - Burcu Yuksel
- Antalya Training and Research Hospital, Neurology Department, Muratpasa, 07050 Antalya, Turkey.
| | - Betul Tekin
- Rumeli Hospital Neurology Department, Kucukcekmece, 34295 Istanbul, Turkey
| | - Hande Sariahmetoglu
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Bakirkoy, 34147 Istanbul, Turkey
| | - Dilek Atakli
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Bakirkoy, 34147 Istanbul, Turkey
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Han MJ, Kim SJ. Effects of Antiepileptic Drugs on Language Abilities in Benign Epilepsy of Childhood with Centrotemporal Spikes. J Clin Neurol 2018; 14:523-529. [PMID: 30198231 PMCID: PMC6172516 DOI: 10.3988/jcn.2018.14.4.523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 01/28/2023] Open
Abstract
Background and Purpose This study is to assess the responsiveness of electroencephalography (EEG) abnormalities and their effects on language ability after initiating different types of antiepileptic therapy in children with newly diagnosed benign epilepsy of childhood with centrotemporal spikes (BECTS). Methods The records of patients newly diagnosed with BECTS (n=120; 69 males) were reviewed retrospectively. The patients were randomly treated with lamotrigine, oxcarbazepine, or topiramate monotherapy, and underwent at least two EEG and standardized language tests. Effects were compared using Pearson's chi-square tests and paired t-tests. Results The recurrence rates for seizures in the lamotrigine, topiramate, and oxcarbazepine groups were 19.4%, 21.7%, and 11.4%, respectively, while complete or partial recovery (as indicated by EEG) occurred in 32%, 39%, and 16% of the patients. Patients in the lamotrigine group showed significant improvements in all parameters assessed by the Test of Language Problem Solving Abilities, except for ‘determining cause.’ Patients in the oxcarbazepine group also showed improvements, except for ‘making inferences’ (p<0.05). Most linguistic index scores were worse in the topiramate group except for Mean Length of Utterance in Words. Patients in the lamotrigine and oxcarbazepine groups showed significant improvements in the receptive language test (p<0.05). EEG improvements were not related to language ability. Conclusions The improvements in language and problem-solving performance in children with BECTS were greater for lamotrigine and oxcarbazepine than for topiramate. However, EEG remission did not imply that language function would be improved after the treatments.
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Affiliation(s)
- Min Jeong Han
- Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea
| | - Sun Jun Kim
- Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University, Chonbuk National University Medical School, Jeonju, Korea.
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Lima EM, Rzezak P, Dos Santos B, Gentil L, Montenegro MA, Guerreiro MM, Valente KD. The relevance of attention deficit hyperactivity disorder in self-limited childhood epilepsy with centrotemporal spikes. Epilepsy Behav 2018; 82:164-169. [PMID: 29649723 DOI: 10.1016/j.yebeh.2018.03.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 03/13/2018] [Accepted: 03/13/2018] [Indexed: 12/28/2022]
Abstract
In this study, we aimed to evaluate the attentional and executive functions in patients with benign childhood epilepsy with centrotemporal spikes (BCECTS) with and without attention-deficit hyperactivity disorder (ADHD) compared with controls and compared with patients with ADHD without epilepsy. We evaluated 12 patients with BCECTS and ADHD (66.7% boys; mean age of 9.67years); 11 children with non-ADHD BCECTS (63.6% boys; mean age of 11.91years); 20 healthy children (75% boys; mean age of 10.15years); and 20 subjects with ADHD without epilepsy (60% boys; mean age of 10.9years). We used a comprehensive battery of neuropsychological tests to evaluate attentional and executive functions in their broad domains. Patients with BCECTS and ADHD had worse performance in Conners' Continuous Performance Test II (reaction time standard error [p=0.008], variability [p=0.033], perseverations [p=0.044] and in reaction time interstimuli interval [p=0.016]). Patients with ADHD showed worse performance in Trail Making Test B errors [p=0.012]. In conclusion, patients with BCECTS and ADHD had worse executive and attentional performance compared with controls than non-ADHD patients with BCECTS. Regardless of the presence of epilepsy, ADHD also negatively impacted executive and attentional functions but in different executive subdomains compared with patients with epilepsy.
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Affiliation(s)
- Ellen Marise Lima
- Department of Psychiatry, Hospital das Clinicas, University of São Paulo-HCFMUSP, Sao Paulo, Brazil
| | - Patricia Rzezak
- Department of Psychiatry, Hospital das Clinicas, University of São Paulo-HCFMUSP, Sao Paulo, Brazil
| | | | - Letícia Gentil
- Department of Psychiatry, Hospital das Clinicas, University of São Paulo-HCFMUSP, Sao Paulo, Brazil
| | - Maria A Montenegro
- Department of Neurology, University of Campinas - UNICAMP, Sao Paulo, Brazil
| | | | - Kette D Valente
- Department of Psychiatry, Hospital das Clinicas, University of São Paulo-HCFMUSP, Sao Paulo, Brazil.
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Camfield C, Camfield P. Cognitive Disabilities and Long-term Outcomes in Children with Epilepsy: A Tangled Tail. Semin Pediatr Neurol 2017; 24:243-250. [PMID: 29249504 DOI: 10.1016/j.spen.2017.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cognitive problems ranging from mild specific learning problems to profound intellectual disability (ID) are very common in children with epilepsy. For most affected patients there is good evidence that the cognitive problems are present at the onset of seizures and do not deteriorate over time. There is no evidence that a few seizures lead to cognitive deterioration. An exception may occur in children with epileptic encephalopathies, although this contention is not always easy to prove. ID is a strong predictor of intractable epilepsy, and the greater the degree of the ID the greater the risk of medication resistant epilepsy. It is not known if specific learning disorders are associated with more severe epilepsy. Rolandic epilepsy is unusual because possibly one-third of patients have transient cognitive and behavioral difficulties during the active phase but later have normal adult social outcome. More longitudinal studies with baseline and repeated cognitive assessments are needed to fully understand the relationship of cognitive problems to childhood onset epilepsy.
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Affiliation(s)
- Carol Camfield
- Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Peter Camfield
- Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
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Wickens S, Bowden SC, D'Souza W. Cognitive functioning in children with self-limited epilepsy with centrotemporal spikes: A systematic review and meta-analysis. Epilepsia 2017; 58:1673-1685. [DOI: 10.1111/epi.13865] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2017] [Indexed: 01/08/2023]
Affiliation(s)
- Steven Wickens
- Melbourne School of Psychological Sciences; University of Melbourne; Parkville Victoria Australia
| | - Stephen C. Bowden
- Department of Clinical Neurosciences; St. Vincent's Hospital Melbourne; Fitzroy Victoria Australia
| | - Wendyl D'Souza
- Department of Medicine; St. Vincent's Hospital; University of Melbourne; Fitzroy Victoria Australia
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Banaskiwitz NHVC, Miziara CSMG, Xavier AB, Manreza MLGD, Trevizol AP, Dias ÁM, Serafim ADP. Cognitive impact in children with “benign” childhood focal epilepsy with centrotemporal spikes. ARCH CLIN PSYCHIAT 2017. [DOI: 10.1590/0101-60830000000129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Gascoigne MB, Smith ML, Barton B, Webster R, Gill D, Lah S. Attention deficits in children with epilepsy: Preliminary findings. Epilepsy Behav 2017; 67:7-12. [PMID: 28086190 DOI: 10.1016/j.yebeh.2016.11.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/13/2016] [Accepted: 11/07/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Attention difficulties are a common clinical complaint among children with epilepsy. We aimed to compare a range of attentional abilities between groups of children with two common epilepsy syndromes, Temporal Lobe Epilepsy (TLE) and Idiopathic Generalized Epilepsy (IGE), and to healthy controls. We also investigated whether epilepsy factors (laterality of seizure focus, epilepsy onset, duration, and severity) were related to attentional abilities. METHODS Multiple dimensions of attention (selective, sustained, and divided attention and attentional control) were assessed directly with standardized neuropsychological measures in 101 children aged 6-16years (23 children with TLE, 20 with IGE and 58 healthy controls). Attention was also assessed indirectly, via a parent-report measure. RESULTS Children with TLE performed worse than children with IGE (p=0.013) and healthy controls (p<0.001) on a test of attentional control, but no between-group differences were apparent on tests of other attentional abilities. Compared to healthy controls, greater attention problems were reported by parents of children with TLE (p=0.006) and IGE (p=0.012). Left-hemisphere seizure focus and greater epilepsy severity were associated with poorer attentional control and sustained-divided attention, respectively, but no other epilepsy factors were associated with attentional abilities. SIGNIFICANCE These findings suggest that children with localization-related epilepsy, but not generalized epilepsy, may be at risk of deficits in attentional control. Interventions aimed at improving attentional control may be targeted at children with localization-related epilepsy, particularly those with a left-hemisphere seizure focus, who appear to be particularly susceptible to this type of attentional deficit.
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Affiliation(s)
- Michael B Gascoigne
- School of Psychological Sciences, Australian College of Applied Psychology, Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders Sydney, New South Wales, Australia; School of Psychology, The University of Sydney, Australia.
| | - Mary Lou Smith
- The University of Toronto, Toronto, Canada; ARC Centre of Excellence in Cognition and its Disorders Sydney, New South Wales, Australia; The Hospital for Sick Children, Toronto, Canada
| | - Belinda Barton
- Children's Hospital Education Research Institute, The Children's Hospital at Westmead and Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Australia
| | - Richard Webster
- T.Y. Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, Australia
| | - Deepak Gill
- T.Y. Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, Australia
| | - Suncica Lah
- ARC Centre of Excellence in Cognition and its Disorders Sydney, New South Wales, Australia; School of Psychology, The University of Sydney, Australia
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Liu MJ, Su XJ, MD XYS, Wu GF, Zhang YQ, Gao L, Wang W, Liao JX, Wang H, Mai JN, Gao JY, Shu XM, Huang SP, Zhang L, Zou LP. Clinical features of benign epilepsy of childhood with centrotemporal spikes in chinese children. Medicine (Baltimore) 2017; 96:e5623. [PMID: 28121917 PMCID: PMC5287941 DOI: 10.1097/md.0000000000005623] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This multicenter clinical trial was conducted to examine current practice of benign epilepsy with centrotemporal spikes and especially address the question that in what circumstances 1 antiepileptic drug (AED) should be preferred.Twenty-five medical centers participate in this clinical trial. The general information, clinical information, and treatment status were collected under the guidance of clinicians and then analyzed. Difference between different treatment groups was compared, and usefulness of the most commonly used AEDs was evaluated.A total of 1817 subjects were collected. The average age of the subject was 8.81 years. The average age of onset is 6.85 years (1-14 years). Male-to-female ratio is 1.13:1. A total of 62.9% of the patients are receiving monotherapies, and 10.6% are receiving multidrug therapy. Both age and course of disease of treated rolandic epilepsy (RE) patients are significantly different from those of untreated patients. Bilateral findings on electroencephalography (EEG) are less seen in patients with monotherapy compared with patients with multidrug therapy. Except for 25.4% patients not taking any AEDs, oxcarbazepine (OXC), sodium valproate (VPA), and levetiracetam (LEV) are the most commonly used 3 AEDs. VPA and LEV are commonly used in add-on therapy. OXC and LEV are more effective as monotherapy than VPA.Age of onset of Chinese RE patients is 6.85 years. Bilateral findings on EEG could be a risk factor to require multidrug therapy. In Chinese patients, OXC, VPA, and LEV are most commonly used AEDs as monotherapy and OXC and LEV are more effective than VPA.
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Affiliation(s)
- Meng-Jia Liu
- Department of Pediatrics, Chinese PLA General Hospital
- Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing
| | - Xiao-jun Su
- Department of Pediatrics, Chinese PLA General Hospital
- Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing
| | - Xiu-Yu Shi MD
- Department of Pediatrics, Chinese PLA General Hospital
- Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing
| | - Ge-fei Wu
- Department of Neurology, Wuhan Children's Hospital Wuhan Shi, Hubei Sheng
| | - Yu-qin Zhang
- Department of Neurology, Tianjin Children's Hospital, Tianjin
| | - Li Gao
- Department of Pediatrics, Henan Province People's Hospital, Henan
| | - Wei Wang
- Department of Neurology, Harbin Children's Hospital, Heilongjiang Sheng
| | - Jian-xiang Liao
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen Shi, Guangdong Sheng
| | - Hua Wang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang Shi, Liaoning Sheng
| | - Jian-ning Mai
- Department of Neurology, Guangzhou Women's and Children's Medical Center, Guangzhou
| | - Jing-yun Gao
- Department of Neurology, Tangshan Women's Children's Hospital, Tangshan Shi, Hebei Sheng
| | - Xiao-mei Shu
- Department of Pediatrics, Affiliated Hospital of Zunyi Medical College, Zunyi
| | - Shao-ping Huang
- Department of Pediatrics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an
| | - Li Zhang
- Department of Pediatrics, Linyi People's Hospital, Linyi, China
| | - Li-Ping Zou
- Department of Pediatrics, Chinese PLA General Hospital
- Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing
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Casali RL, Amaral MIRD, Boscariol M, Lunardi LL, Guerreiro MM, Matas CG, Colella-Santos MF. Comparison of auditory event-related potentials between children with benign childhood epilepsy with centrotemporal spikes and children with temporal lobe epilepsy. Epilepsy Behav 2016; 59:111-6. [PMID: 27131051 DOI: 10.1016/j.yebeh.2016.03.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/13/2016] [Accepted: 03/14/2016] [Indexed: 11/18/2022]
Abstract
The abnormal brain discharges observed in benign childhood epilepsy with centrotemporal spikes (BECTS) and temporal lobe epilepsy (TLE) are located close to areas responsible for auditory and language processing. This study aimed to analyze the results of auditory event-related potentials (P300) in children with BECTS and TLE in order to assess whether the epileptic activity in centrotemporal and temporal regions may compromise the integrity and physiology of auditory system structures. This was a prospective, comparative, and cross-sectional study. Group I (GI) consisted of 13 children diagnosed with BECTS, group II (GII), 7 children diagnosed with TLE, and control group (GIII), 16 healthy children, with no hearing or academic complaints. After neurological and basic audiological assessments, P300 was applied. The P300 latency and amplitude were compared between groups. Regarding latency, GI showed 324.1 (+31.5) ms, GII 336.3 (+23.5) ms, and GIII 318 (+27.7) ms. Amplitudes were 4.80 (+3.2) μV in GI, 4.7 (+2.5) μV in GII, and 5.8 (+2.4) μV in GIII. Although children with BECTS showed prolonged latencies and reduced amplitudes, these differences were not considered statistically significant. Children with TLE showed statistically significant prolonged P300 latency compared with the control group (P=0.037). We speculate that abnormal electrical discharges in centrotemporal and temporal regions led to the slowing of auditory processing in our sample.
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Affiliation(s)
- Raquel Leme Casali
- Child and Adolescent Health Program, Center for Investigation in Pediatrics, Faculty of Medical Sciences, State University of Campinas (FCM/UNICAMP), Brazil.
| | - Maria Isabel Ramos do Amaral
- Child and Adolescent Health Program, Center for Investigation in Pediatrics, Faculty of Medical Sciences, State University of Campinas (FCM/UNICAMP), Brazil.
| | - Mirela Boscariol
- Department of Neurology, Faculty of Medical Sciences, State University of Campinas (FCM/UNICAMP), Brazil.
| | - Luciane Lorencetti Lunardi
- Department of Neurology, Faculty of Medical Sciences, State University of Campinas (FCM/UNICAMP), Brazil.
| | | | - Carla Gentile Matas
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, Faculty of Medicine, University of São Paulo (USP), Brazil.
| | - Maria Francisca Colella-Santos
- Department of Human Development and Rehabilitation, Faculty of Medical Sciences, State University of Campinas (FCM/UNICAMP), Brazil.
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21
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Vega YH, Smith A, Cockerill H, Tang S, Agirre-Arrizubieta Z, Goyal S, Pina M, Akman CI, Jolleff N, McGinnity C, Gomez K, Gupta R, Hughes E, Jackman J, McCormick D, Oren C, Scott D, Taylor J, Trounce J, Clarke T, Kugler S, Mandelbaum DE, McGoldrick P, Wolf S, Strug LJ, Pal DK. Risk factors for reading disability in families with rolandic epilepsy. Epilepsy Behav 2015; 53:174-9. [PMID: 26580214 PMCID: PMC4719157 DOI: 10.1016/j.yebeh.2015.10.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 10/14/2015] [Accepted: 10/16/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The high prevalence and impact of neurodevelopmental comorbidities in childhood epilepsy are now well known, as are the increased risks and familial aggregation of reading disability (RD) and speech sound disorder (SSD) in rolandic epilepsy (RE). The risk factors for RD in the general population include male sex, SSD, and ADHD, but it is not known if these are the same in RE or whether there is a contributory role of seizure and treatment-related variables. METHODS An observational study of 108 probands with RE (age range: 3.6-22 years) and their 159 siblings (age range: 1-29 years; 83 with EEG data) were singly ascertained in the US or UK through a proband affected by RE. We used a nested case-control design, multiple logistic regression, and generalized estimating equations to test the hypothesis of an association between RD and seizure variables or antiepileptic drug treatment in RE; we also assessed an association between EEG focal sharp waves and RD in siblings. RESULTS Reading disability was reported in 42% of probands and 22% of siblings. Among probands, RD was strongly associated with a history of SSD (OR: 9.64, 95% CI: 2.45-37.21), ADHD symptoms (OR: 10.31, 95% CI: 2.15-49.44), and male sex (OR: 3.62, 95% CI: 1.11-11.75) but not with seizure or treatment variables. Among siblings, RD was independently associated only with SSD (OR: 4.30, 95% CI: 1.42-13.0) and not with the presence of interictal EEG focal sharp waves. SIGNIFICANCE The principal risk factors for RD in RE are SSD, ADHD, and male sex, the same risk factors as for RD without epilepsy. Seizure or treatment variables do not appear to be important risk factors for RD in probands with RE, and there was no evidence to support interictal EEG focal sharp waves as a risk factor for RD in siblings. Future studies should focus on the precise neuropsychological characterization of RD in families with RE and on the effectiveness of standard oral-language and reading interventions.
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Affiliation(s)
| | | | | | - Shan Tang
- King’s College London, UK,King’s Health Partners, London, UK
| | | | | | | | - Cigdem I Akman
- Department of Neurology, Columbia University, New York, USA
| | - Nicola Jolleff
- East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | | | | | | | | | | | | | | | | | | | | | - Tara Clarke
- Department of Epidemiology, Columbia University, New York, USA
| | - Steven Kugler
- Children’s Hospital of Philadelphia and University of Pennsylvania School of Medicine, PA, USA
| | - David E Mandelbaum
- Hasbro Children’s Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | | | - Lisa J Strug
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto; Canada,Dalla Lana School of Public Health, University of Toronto, Canada
| | - Deb K Pal
- King's College London, UK; King's Health Partners, London, UK.
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fMRI brain response during sentence reading comprehension in children with benign epilepsy with centro-temporal spikes. Epilepsy Res 2015; 117:42-51. [DOI: 10.1016/j.eplepsyres.2015.08.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 07/30/2015] [Accepted: 08/10/2015] [Indexed: 01/21/2023]
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Garzon E. Is rolandic epilepsy really benign? ARQUIVOS DE NEURO-PSIQUIATRIA 2014; 72:821-3. [DOI: 10.1590/0004-282x20140195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 09/26/2014] [Indexed: 11/21/2022]
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Oliveira EP, Neri ML, Capelatto LL, Guimarães CA, Guerreiro MM. Rolandic epilepsy and dyslexia. ARQUIVOS DE NEURO-PSIQUIATRIA 2014; 72:826-31. [DOI: 10.1590/0004-282x20140141] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 07/25/2014] [Indexed: 11/21/2022]
Abstract
Objective Although benign epilepsy with centrotemporal spikes (BECTS) is an idiopathic, age-related epilepsy syndrome with favorable outcome, recent studies have shown impairment in specific neuropsychological tests. The objective of this study was to analyze the comorbidity between dyslexia and BECTS. Method Thirty-one patients with clinical and electroencephalographic diagnosis of BECTS (group A) and 31 paired children (group B) underwent a language and neuropsychological assessment performed with several standardized protocols. Our findings were categorized as: a) dyslexia; b) other difficulties; c) without difficulties. Our results were compared and statistically analyzed. Results Our data showed that dyslexia occurred in 19.4% and other difficulties in 74.2% of our patients. This was highly significant when compared with the control group (p<0.001). Phonological awareness, writing, reading, arithmetic, and memory tests showed a statistically significant difference when comparing both groups. Conclusion Our findings show significant evidence of the occurrence of dyslexia in patients with BECTS.
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Attention-deficit/hyperactivity disorder and attention impairment in children with benign childhood epilepsy with centrotemporal spikes. Epilepsy Behav 2014; 37:54-8. [PMID: 24975822 DOI: 10.1016/j.yebeh.2014.05.030] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 05/25/2014] [Accepted: 05/27/2014] [Indexed: 11/20/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common comorbidity in children with epilepsy and has a negative impact on behavior and learning. The purposes of this study were to quantify the prevalence of ADHD in benign childhood epilepsy with centrotemporal spikes (BCECTS) and to identify clinical factors that affect ADHD or attention impairment in patients with BCECTS. The medical records of 74 children (44 males) with neuropsychological examination from a total of 198 children diagnosed with BCECTS at Asan Medical Center were retrospectively reviewed. Electroclinical factors were compared across patients with ADHD and those without ADHD. Mean T-scores of the continuous performance test were compared across patients grouped according to various epilepsy characteristics. Forty-eight (64.9%) patients had ADHD. A history of febrile convulsion was more common in patients with ADHD than in patients without ADHD (p=0.049). Bilateral centrotemporal spikes on electroencephalogram were more common in patients receiving ADHD medication than in patients with untreated ADHD (p=0.004). Male patients, patients with frequent seizures prior to diagnosis, and patients with a high spike index (≥40/min) on sleep EEG at diagnosis had significantly lower visual selective attention (p<0.05). Children with BCECTS had a high prevalence of ADHD, and frequent seizures or interictal epileptiform abnormalities were closely related to impairment of visual selective attention in children with BCECTS, indicating the need for ADHD or attention impairment screening in children with BCECTS.
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Memory impairment and Benign Epilepsy with centrotemporal spike (BECTS): A growing suspicion. Brain Cogn 2014; 84:123-31. [DOI: 10.1016/j.bandc.2013.11.014] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 11/23/2013] [Accepted: 11/27/2013] [Indexed: 11/18/2022]
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Ayaz M, Kara B, Soylu N, Ayaz AB. Fine motor skills in children with rolandic epilepsy. Epilepsy Behav 2013; 29:322-5. [PMID: 24012511 DOI: 10.1016/j.yebeh.2013.07.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/12/2013] [Accepted: 07/31/2013] [Indexed: 11/27/2022]
Abstract
This study aimed to evaluate fine motor skills in children with rolandic epilepsy (RE). The research included 44 children diagnosed with typical RE and 44 controls matched in terms of age, gender, and level of education. Fine motor skills were evaluated with the Purdue Pegboard Test, and intelligence was measured with the Wechsler Intelligence Scale for Children. After controlling for the effect of intelligence on fine motor skills, the results showed that the children with RE did not perform as well as the controls in the PPT dominant hand, both hands, and assembly subtests. Epileptic focus, treatment status, type of antiepileptic treatment, age at the time of the first seizure, time since the last seizure, and total number of seizures did not affect motor skills. Rolandic epilepsy negatively affected fine motor skills regardless of the children's level of intelligence.
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Affiliation(s)
- Muhammed Ayaz
- Sakarya University Training and Research Hospital, Child and Adolescent Psychiatry Outpatient Clinic, Sakarya, Turkey.
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Filippini M, Boni A, Giannotta M, Gobbi G. Neuropsychological development in children belonging to BECTS spectrum: long-term effect of epileptiform activity. Epilepsy Behav 2013; 28:504-11. [PMID: 23896351 DOI: 10.1016/j.yebeh.2013.06.016] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 06/12/2013] [Accepted: 06/18/2013] [Indexed: 11/25/2022]
Abstract
Benign epilepsy with centrotemporal spikes (BECTS) is an idiopathic focal epileptic syndrome in childhood. It is called "benign" because the seizure and cognitive outcomes are usually favorable, but a significant number of children with BECTS present heterogeneous cognitive deficits correlated to NREM sleep epileptiform discharges. The atypical evolutions of BECTS form a spectrum of conditions suggesting that slow sleep nocturnal interictal epileptiform discharges (IEDs) specifically determine the neuropsychological deficit. Few follow-up studies of neuropsychological outcome in BECTS are available, and very often, slow sleep has not been recorded throughout night sleep. The present study analyzed the long-term effects of IEDs during NREM sleep on neuropsychological development in children with rolandic spikes. Thirty-three children with a diagnosis of BECTS were monitored for at least two years. Results show that these children are at higher risk for residual verbal difficulties, and the abnormal neuropsychological development is significantly correlated with a greater frequency of NREM sleep discharges, school-age epilepsy onset, and a higher number of antiepileptic drugs (AEDs). The findings are discussed in terms of how slow sleep IEDs affect the consolidation of verbal skills during critical epochs of neuropsychological development.
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Affiliation(s)
- Melissa Filippini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Child Neurology Unit, Ospedale Bellaria, Via Altura 3, 40139 Bologna, Italy.
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Jurkevičienė G, Endzinienė M, Laukienė I, Šaferis V, Rastenytė D, Plioplys S, Vaičienė-Magistris N. Association of language dysfunction and age of onset of benign epilepsy with centrotemporal spikes in children. Eur J Paediatr Neurol 2012; 16:653-61. [PMID: 22560726 DOI: 10.1016/j.ejpn.2012.03.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2011] [Revised: 03/14/2012] [Accepted: 03/30/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Language dysfunction in children with benign epilepsy with centrotemporal spikes (BECTS) has been well recognized but data regarding its risk factors are heterogenous. AIMS To assess language function in children with BECTS and its association with the age of epilepsy onset. METHODS We assessed language function in 61 children with BECTS and 35 age and sex-matched controls. Children with BECTS performed significantly worse on all language tasks as compared to controls and overall better language function was positively correlated with older age of the child. Early age at seizure onset demonstrated significant negative correlation with language dysfunction, age below 6 years being related to the lowest performance scores. There was no relationship between the language function and the laterality of epileptic focus, seizure treatment status, or the duration of epilepsy. CONCLUSION Children with BECTS have language difficulties that are more pronounced in younger age group. Despite better language functioning in older children with BECTS, their verbal abilities remain inferior to those of children without epilepsy. Early age at seizure onset is a significant factor predicting worse language functioning in children with BECTS.
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Affiliation(s)
- Giedrė Jurkevičienė
- Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Pąchalska M, Kropotov ID, Mańko G, Lipowska M, Rasmus A, Łukaszewska B, Bogdanowicz M, Mirski A. Evaluation of a neurotherapy program for a child with ADHD with Benign Partial Epilepsy with Rolandic Spikes (BPERS) using event-related potentials. Med Sci Monit 2012; 18:CS94-104. [PMID: 23111748 PMCID: PMC3560598 DOI: 10.12659/msm.883531] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 05/11/2012] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND We hypothesized that there would be a good response to relative beta training, applied to regulate the dynamics of brain function in a patient with benign partial epilepsy with Rolandic Spikes (BPERS), associated with neuropsychiatric deficits resembling the symptoms of attention deficit-hyperactivity disorder (ADHD). CASE REPORT The patient, E.Z., age 9.3, was suffering from neuropsychiatric symptoms, cognitive dysfunction, especially attention deficits, and behavioral changes, rendering him unable to function independently in school and in many situations of everyday life. He was treated for epilepsy, but only slight progress was made. The patient took part in 20 sessions of relative beta training combined with behavioral training. We used standardized neuropsychological testing, as well as ERPs before the experiment and after the completion of the neurotherapy program. Neuropsychological testing at baseline showed multiple cognitive deficits. Over the course of neurotherapy, E.Z.'s verbal and non-verbal IQ increased significantly. His cognitive functions also improved, including immediate and delayed logical and visual recall on the WMS-III, maintaining attention on the WMS-III, and executive functions, but remained below norms. Physiologically, the patient showed substantial changes after neurotherapy, including fewer spikes and an increased P300 NOGO component. CONCLUSIONS The cognitive deficits characteristic for ADHD in a child with BPERS may be unresponsive to antiepileptic treatment, but are reversible after a carefully selected neurotherapy program, combined with antiepileptic treatment. Event Related Potentials (ERPs) in the GO/NOGO task can be used to assess functional brain changes induced by neurotherapeutical programs.
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Does a normalizing electroencephalogram in benign childhood epilepsy with centrotemporal spikes abort attention deficit hyperactivity disorder? Pediatr Neurol 2012; 47:279-83. [PMID: 22964442 DOI: 10.1016/j.pediatrneurol.2012.06.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Accepted: 06/15/2012] [Indexed: 11/23/2022]
Abstract
This retrospective study delineated the efficacy of antiepileptic drugs in preventing the need for methylphenidate in patients with benign childhood epilepsy with centrotemporal spikes and attention deficit hyperactivity disorder. Seventeen patients were identified. A reduction of electroencephalogram pathologic activity by more than 50% was achieved in some patients with the antiepileptic drugs levetiracetam, sulthiame, lamotrigine, clobazam, and valproic acid. Complete normalization was achieved in two patients with sulthiame. Improvement in attention along with the reduction of pathologic electroencephalogram activity was observed in four patients, two with sulthiame, and one each with lamotrigine and levetiracetam (which was ceased because of suicidal tendencies). However, this improvement in attention was either temporary or not significant enough to discontinue methylphenidate. Methylphenidate was eventually prescribed to all patients.
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Capelatto LLM, Oliveira EPM, Neri ML, Guimarães CA, Montenegro MA, Guerreiro MM. Clinical and neuropsychological correlation in patients with rolandic epilepsy. ARQUIVOS DE NEURO-PSIQUIATRIA 2012; 70:691-693. [PMID: 22990725 DOI: 10.1590/s0004-282x2012000900008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 05/11/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To evaluate the presence of neurological soft signs (NSS) and to correlate them with the Wechsler Intelligence Scale for Children (WISC III) in patients with rolandic epilepsy (RE). METHODS Forty children and adolescents aged between 9 and 15 years were studied. They were divided into two groups: G1 - patients with RE (n=20) - and G2 - healthy controls without epilepsy (n=20). They were assessed with the Quick Neurological Screening Test (QNST II) - clinical trial to search for NSS -, and the WISC III - neuropsychological test. RESULTS No statistical difference between groups was found in WISC III and QNST II. However, children with poorer motor skills had worse performance in the QNST II and also in the execution intelligence quotient - IQ (p=0.001) and in total IQ (p=0.004), thus showing a positive correlation between them. CONCLUSIONS The QNST II is a good screening tool for the neurologist to detect abnormalities in fine motor skills.
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Affiliation(s)
- Lívia L Medeiros Capelatto
- Department of Neurology, Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (Unicamp), Campinas SP, Brazil
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Neri ML, Guimarães CA, Oliveira EP, Duran MH, Medeiros LL, Montenegro MA, Boscariol M, Guerreiro MM. Neuropsychological assessment of children with rolandic epilepsy: executive functions. Epilepsy Behav 2012; 24:403-7. [PMID: 22683244 DOI: 10.1016/j.yebeh.2012.04.131] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 04/12/2012] [Accepted: 04/21/2012] [Indexed: 10/28/2022]
Abstract
Rolandic epilepsy (RE) is the most common type of childhood focal epilepsy. Although there is no intellectual deficit, children with RE may have specific cognitive impairments. The aims of this study were to identify changes in executive functions in children with RE and to verify the influence of epilepsy and seizure variables. We evaluated 25 children with RE and 28 healthy controls. A comprehensive neuropsychological battery was utilized. The results showed that the RE children had worse performance than the control group in some categories of the Wisconsin Card Sorting Test, the Trail Making Test part B, and the Verbal Fluency Test (FAS). Children with earlier onset of epilepsy had worse performance when compared with children with later onset of epilepsy. We conclude that children with RE may show a deficit in executive function despite their normal IQ. The set of tests was more extensive than what was previously used in other studies. Our study suggests that early seizures can interfere with brain development. Regarding cognition, the term benign should be used cautiously in RE.
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Affiliation(s)
- Marina L Neri
- Department of Neurology, University of Campinas, Campinas, SP, Brazil
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You SJ. Cognitive function of idiopathic childhood epilepsy. KOREAN JOURNAL OF PEDIATRICS 2012; 55:159-63. [PMID: 22670150 PMCID: PMC3362729 DOI: 10.3345/kjp.2012.55.5.159] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 02/26/2012] [Indexed: 11/27/2022]
Abstract
Most children with epilepsy are of normal intelligence. However, a significant subset will have temporary or permanent cognitive impairment. Factors that affect cognitive function are myriad and include the underlying neuropathology of the epilepsy, seizures, epileptiform discharges, psychosocial problems, age at seizure onset, duration of epilepsy, and side effects associated with antiepileptic drugs. This review article discusses cognitive function in children with idiopathic epilepsy and the effects of antiepileptic drugs on cognitive function in children.
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Affiliation(s)
- Su Jeong You
- Department of Pediatrics, Epilepsy Center, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Smith AB, Kavros PM, Clarke T, Dorta NJ, Tremont G, Pal DK. A neurocognitive endophenotype associated with rolandic epilepsy. Epilepsia 2012; 53:705-11. [PMID: 22220688 PMCID: PMC3319239 DOI: 10.1111/j.1528-1167.2011.03371.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Children with rolandic epilepsy (RE) experience difficulties with reading, language, and attention. Their siblings are at high risk of dyslexia but are not otherwise known to have neurocognitive deficits. We therefore sought evidence for an RE-associated neurocognitive endophenotype. METHODS Thirteen probands (male-to-female ratio 9:4) and 11 epilepsy-free siblings (male-to-female ratio 5:6) completed a neurocognitive evaluation within the domains of reading, language, and attention. Frequencies of impairment were compared, and mean standardized scores of children with RE and their siblings were each compared against population means. KEY FINDINGS Frequency of impairment in each domain was comparable for siblings and probands: 9% of siblings and 31% of probands were reading impaired; 36% of siblings and 54% of probands were language impaired; and 70% of siblings and 67% of probands had attention impairments. Comparison of differences between sample and population means revealed evidence of a similar pattern of language deficits in both groups, specifically for picture naming and attention to competing words. For measures of attention, both groups made significantly higher omission errors and were impaired in their ability to sustain attention. SIGNIFICANCE Children with RE and unaffected siblings demonstrate neurocognitive impairments in the domains of language and attention that are likely to remain undetected with general clinical protocols. Neurocognitively impaired probands and siblings showed a remarkably similar profile of deficits in language and attention that could explain poor academic performance. Early evaluation and intervention may benefit these children academically.
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Affiliation(s)
- Anna B Smith
- MRC Social Genetic and Developmental Psychiatry Centre, King's College London, Institute of Psychiatry, London, UK
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Impact of benign childhood epilepsy with centrotemporal spikes (BECTS) on school performance. Seizure 2012; 21:87-91. [DOI: 10.1016/j.seizure.2011.09.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 09/05/2011] [Accepted: 09/05/2011] [Indexed: 11/22/2022] Open
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Lin JJ, Riley JD, Hsu DA, Stafstrom CE, Dabbs K, Becker T, Seidenberg M, Hermann BP. Striatal hypertrophy and its cognitive effects in new-onset benign epilepsy with centrotemporal spikes. Epilepsia 2012; 53:677-85. [PMID: 22360313 DOI: 10.1111/j.1528-1167.2012.03422.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE Benign epilepsy with centrotemporal spikes (BECTS), the most common childhood epilepsy syndrome, is a neurodevelopmental disorder with a genetic influence. Despite its signature electroencephalographic pattern and distinct focal motor seizure semiology, little is known about the underlying brain anatomic alteration and the corresponding cognitive consequences. Given the motor manifestations of seizures in BECTS, we hypothesize that anatomic networks in BECTS involve a distributed corticostriatal circuit. METHODS We investigated volumetric differences and shape deformities of caudate, putamen, pallidum, and thalamus in a group of children with new- and recent-onset BECTS (N = 3) compared to healthy controls (N = 54). We correlated specific subcortical volumes in BECTS that were significantly different from those in healthy controls with performances in executive function. KEY FINDINGS Children with BECTS demonstrated significantly hypertrophied putamen, which was selective among the subcortical regions examined. Shape analysis showed dorsoventral elongation of the left caudate and bilateral putamen, with subnuclei expansion in ventral and dorsal striatum. Larger putamen volumes were linked to better cognitive performances on two complementary executive function tests. SIGNIFICANCE Children with BECTS showed aberrant volume and shape in subcortical regions that are critical for both motor processing and executive function. It is of importance to note that the hypertrophy appears to be cognitively adaptive, as enlargement was associated with improved cognitive performances. The anatomic abnormalities and their cognitive effects are evident in a group of children with new- and recent-onset epilepsy, suggesting that the structural brain anomalies occurred before the diagnosis of epilepsy.
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Affiliation(s)
- Jack J Lin
- Department of Neurology, University of California, Irvine, California 92697, USA.
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Genizi J, Shamay-Tsoory SG, Shahar E, Yaniv S, Aharon-Perez J. Impaired social behavior in children with benign childhood epilepsy with centrotemporal spikes. J Child Neurol 2012; 27:156-61. [PMID: 21868370 DOI: 10.1177/0883073811414420] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of the present study was to assess the emotional and cognitive aspects of social cognition among patients with rolandic epilepsy. A computerized neuropsychological battery was used for cognitive evaluation. Affective and cognitive social cognition were evaluated using two computerized Theory of Mind tasks. Cognitive abilities and social behavior of 15 children, diagnosed with rolandic epilepsy, ages 7 to 13 years were assessed and compared with 15 age- and education-matched healthy controls. Compared with controls, the epileptic patients had lower scores on verbal and visual learning rate parameters and on verbal processing and were significantly impaired on "affective Theory of Mind" tasks but not on "cognitive Theory of Mind" conditions. Our findings raise the possibility that rolandic epilepsy may affect neural networks affecting cognition and mediating social cognition essential for social behavior, thus challenging the benign nature of the condition.
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Affiliation(s)
- Jacob Genizi
- Pediatric Department, Bnai Zion Medical Center, Rappaport School of Medicine, Technion, Haifa.
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Ewen JB, Vining EP, Smith CA, Trescher WH, Kossoff EH, Gordon B, Boatman-Reich D. Cognitive and EEG fluctuation in benign childhood epilepsy with central-temporal spikes: a case series. Epilepsy Res 2011; 97:214-9. [PMID: 21920705 DOI: 10.1016/j.eplepsyres.2011.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 07/18/2011] [Accepted: 07/31/2011] [Indexed: 10/17/2022]
Abstract
Aware of parental reports of academic variability, we investigated month-to-month fluctuations in cognitive abilities and EEG status by repeated measures testing in six children with benign epilepsy with central-temporal spikes (BECTS). All showed greater than normal test-retest variability. Daytime EEG abnormalities were also variable. Short-term fluctuations in cognitive function appear common in children with BECTS, potentially impacting academic performance.
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Affiliation(s)
- Joshua B Ewen
- Kennedy Krieger Institute, Neurology and Developmental Medicine, 707N Broadway Baltimore, MD 21205, United States.
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Bedoin N, Ferragne E, Lopez C, Herbillon V, De Bellescize J, des Portes V. Atypical hemispheric asymmetries for the processing of phonological features in children with rolandic epilepsy. Epilepsy Behav 2011; 21:42-51. [PMID: 21470917 DOI: 10.1016/j.yebeh.2011.02.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 02/23/2011] [Accepted: 02/24/2011] [Indexed: 10/18/2022]
Abstract
We assessed language lateralization in 177 healthy 4- to 11-year-old children and adults and atypical asymmetries associated with unilateral epileptic foci in 18 children with benign epilepsy with centrotemporal spikes (BECTS). Dichotic listening results revealed two indices of immature functional asymmetry when the focus was left-sided (BECTS-L). First, children with BECTS-L did not show left hemisphere dominance for the processing of place of articulation, which was recorded in children with BECTS-R and control children. On the contrary, healthy children exhibited a gradual increase in left hemisphere dominance for place processing during childhood, which is consistent with the shift from global to finer-grained acoustic analysis predicted by the Developmental Weighting Shift model. Second, children with BECTS-L showed atypical left hemisphere involvement in the processing of the voiced value (+V), associated with a long acoustic event in French stop consonants, whereas right hemisphere dominance increased with age for +V processing in healthy children. BECTS-L, therefore, interferes with the development of left hemisphere dominance for specific phonological mechanisms.
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Affiliation(s)
- Nathalie Bedoin
- Laboratoire Dynamique du Langage, CNRS UMR 5596, Lyon, France.
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Verrotti A, D'Egidio C, Agostinelli S, Parisi P, Chiarelli F, Coppola G. Cognitive and linguistic abnormalities in benign childhood epilepsy with centrotemporal spikes. Acta Paediatr 2011; 100:768-72. [PMID: 21284714 DOI: 10.1111/j.1651-2227.2011.02159.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To assess the cognitive function and language ability in children with benign partial epilepsy with centrotemporal spikes. METHODS Twenty-five patients with benign partial epilepsy with centrotemporal spikes were included. They were divided into two subgroups. Group I: 10 patients with rolandic focus who were not treated. Group II: 15 patients with rolandic focus receiving treatment. A third Group of 12 healthy subjects have been studied. All children underwent standardized neuropsychological testing: electroencephalogram recording, Wechsler Intelligence Scale for Children-revised, Peabody Picture Vocabulary Test-III (PPVT-III) and Boston Naming Test (BNT), both during active disease (T1) and 2 years after recovery from epilepsy (T2). RESULTS At T1 evaluation, no significant differences in group I and II patients about general intelligence, when compared with controls, were found. Group I and II patients were impaired with respect to controls in the receptive and expressive vocabulary evaluated with PCVT-III and BNT, respectively. At T2 evaluation, group I and II patients showed a normalization of the language abnormalities. CONCLUSION Deficits of speech-related abilities can be detected in children with this type of epilepsy: these dysfunctions seem to be independent of the effects of antiepileptic treatment and are reversible after remission of epilepsy.
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Affiliation(s)
- A Verrotti
- Department of Paediatrics, University of Chieti, Italy.
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Abstract
INTRODUCTION Learning Disorders (LD) are defined as disorders that interfere with academic performance or with daily activities that require reading, writing or mathematical skills in subjects with a normal intelligence quotient (IQ). The prevalence of LD in the general population has been found to be 2-10%, and reading disorders are the most frequent subtype. Epilepsy is one of the most common serious neurological disorders in childhood. LD are more common in children with epilepsy than in the general population. As a consequence, the risk of cognitive impairment in children with epilepsy is high, and a review of the literature needs to be fully presented. METHODS Narrative review including articles regarding LD in children with various epileptic syndromes published in the international medical literature. RESULTS LD are more frequent among children with epilepsy. The etiology is multifactorial, being affected by the type of epileptic syndrome, the age of onset and the antiepileptic treatment being selected. LD can be either permanent or state-dependent. Each category has different treatment protocols and prognosis. CONCLUSIONS Despite the fact that the findings of the studies discussed in our article support the evidence that epilepsy in childhood impairs the cognitive function, we should not underestimate the role of demographic and psychosocial factors on academic performance of children with epilepsy. Despite the high prevalence of LD, a healthy family and school environment can help reduce its impact on the patient's quality of life.
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Cerminara C, D'Agati E, Lange KW, Kaunzinger I, Tucha O, Parisi P, Spalice A, Curatolo P. Benign childhood epilepsy with centrotemporal spikes and the multicomponent model of attention: a matched control study. Epilepsy Behav 2010; 19:69-77. [PMID: 20719570 DOI: 10.1016/j.yebeh.2010.07.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 07/07/2010] [Accepted: 07/07/2010] [Indexed: 11/24/2022]
Abstract
Although the high risk of cognitive impairments in benign childhood epilepsy with centrotemporal spikes (BCECTS) is now well established, there is no clear definition of a uniform neurocognitive profile. This study was based on a neuropsychological model of attention that assessed various components of attention in 21 children with BCECTS and 21 healthy children. All participants were tested with a computerized test battery using the multicomponent model of attention performance. In comparison with healthy participants, the children with BCECTS showed significant impairment in the measure of selectivity and in one measure of intensity of attention (arousal). Our results did not correlate with the electroclinical variables of age at onset of seizures and spike index on sleep EEGs. To the best of our knowledge, this is the first study in which the multicomponent model of attentional function has been used in children with BCECTS to provide a clearer neuropsychological profile of these patients.
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Affiliation(s)
- Caterina Cerminara
- Unit of Child Neurology and Psychiatry, Department of Neuroscience, University of Rome Tor Vergata, Rome, Italy.
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Tedrus GM, Fonseca LC, Castilho DP, Pacheco EM, Campregher AA, Bittar MC. Benign childhood epilepsy with centro-temporal spikes: evolutive clinical, cognitive and EEG aspects. ARQUIVOS DE NEURO-PSIQUIATRIA 2010; 68:550-5. [DOI: 10.1590/s0004-282x2010000400014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Accepted: 12/30/2009] [Indexed: 11/22/2022]
Abstract
Thirty-two children with benign childhood epilepsy with centrotemporal spikes (BECTS) were studied for a mean period of 27.6 months. The characteristics of the seizures, electroencephalogram (EEG), WISC-III and School Performance Test were compared at the start and end of the study. Nine (28.1%) children continued having seizures. Epileptiform activity (EA) on the EEG reduced in number and was no longer recorded in 6 (18.7%) children. There was a significant improvement in the performance and perceptual organization IQ values. The improvement in reading performance failed to reach statistical significance. The performance in arithmetic worsened in 43.7% of the children, and this was associated with the persistence of epileptic seizures. There were no significant correlations between changes in cognitive aspects and characteristics of EA. There is a need to continue this study, and also search for other factors influencing the evolution of cognitive abilities in children with BECTS.
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Loutfi KS, Carvalho AM. Possíveis interfaces entre TDAH e epilepsia. JORNAL BRASILEIRO DE PSIQUIATRIA 2010. [DOI: 10.1590/s0047-20852010000200011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Identificar na literatura elementos para explicar uma possível associação entre o transtorno de déficit de atenção e hiperatividade (TDAH) e a epilepsia e orientar quanto ao manejo clínico dos pacientes que compartilham esses transtornos. MÉTODOS: Realizou-se revisão da literatura dos últimos 10 anos nas bases de dados MedLine e Lilacs com a combinação dos descritores "attention deficit hyperactivity disorder", "ADHD" e "epilepsy". RESULTADOS: Sintomas de TDAH são frequentes em síndromes epilépticas idiopáticas. Vários fatores podem contribuir para a coexistência desses transtornos: 1) possibilidade de uma mesma propensão genética; 2) participação dos neurotransmissores noradrenalina e dopamina no TDAH e na modulação da excitabilidade neuronal; 3) anormalidades estruturais do cérebro evidenciadas em epilépticos portadores de TDAH; 4) influência dos efeitos crônicos das crises e das descargas epileptiformes interictais sob a atenção; 5) efeitos adversos das drogas antiepilépticas sob a cognição. CONCLUSÕES: As evidências atuais apontam que crises epilépticas e TDAH podem apresentar bases neurobiológicas comuns. Estudos que avaliam disfunções nas vias de sinalização das catecolaminas cerebrais e o papel das descargas epileptiformes interictais na geração dos sintomas são fundamentais na investigação desses mecanismos. Drogas psicoestimulantes são seguras e eficazes para o tratamento do TDAH na maioria dos portadores de epilepsia.
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Lillywhite LM, Saling MM, Simon Harvey A, Abbott DF, Archer JS, Vears DF, Scheffer IE, Jackson GD. Neuropsychological and functional MRI studies provide converging evidence of anterior language dysfunction in BECTS. Epilepsia 2009; 50:2276-84. [DOI: 10.1111/j.1528-1167.2009.02065.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tedrus GMAS, Fonseca LC, Melo EMV, Ximenes VL. Educational problems related to quantitative EEG changes in benign childhood epilepsy with centrotemporal spikes. Epilepsy Behav 2009; 15:486-90. [PMID: 19631587 DOI: 10.1016/j.yebeh.2009.06.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Accepted: 06/07/2009] [Indexed: 10/20/2022]
Abstract
The relationship between educational problems and clinical/electroencephalographic aspects was assessed in 38 children with benign childhood epilepsy with centrotemporal spikes (BECTS). Children were assessed using the School Performance Test; questionnaires on learning difficulties administered to parents and teachers; the Wechsler Intelligence Scale for Children, Third Edition; and EEGs. Absolute and relative amplitudes in the classic bands (quantitative EEG) and characteristics of epileptiform activity on the EEG were examined. Educational problems were observed in 7 (18.4%) children with BECTS. In this subgroup, relative alpha amplitudes at the central and parietal electrodes were lower as compared with those of the BECTS subgroup with normal educational performance and a control group matched for age, gender, and socioeconomic status. The data indicated a possible relationship between alterations in background brain electrical activity and the tendency toward inferior educational performance in children with BECTS. This study suggested that quantitative EEGs are a possible physiological tool in the assessment of cognitive aspects in children with BECTS.
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Affiliation(s)
- Glória M A S Tedrus
- Department of Neurology, Pontificia Universidade Catolica de Campinas (PUC-Campinas), Av. John Boyd Dunlop, Campinas, Brazil
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Abstract
The goal of this review is to discuss the comorbidities reported in specific epilepsy syndromes to examine possible underlying causes or associations and to present data on current therapies for these conditions. Comorbid conditions including cognitive impairment, neuropsychiatric problems, and social difficulties are common in children with epilepsy, and often more disabling than the seizures themselves. Biological factors associated with a greater risk of comorbidity in epilepsy include younger age at seizure onset, cognitive impairment, temporal or frontal lobe onset, and intractability. Social factors correlating with greater risk include lower socioeconomic status, lower parental education level, and poorer family function. These comorbid conditions not only have a significant impact on the child but also are a source of increased stress and burden for families. Increased awareness and early diagnosis of these conditions may affect therapeutic intervention and long-term outcome as well as assist in better understanding of potential risk factors and biological mechanisms.
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Affiliation(s)
- L D Hamiwka
- Division of Child Neurology, Ohio State University College of Medicine, Columbus, Ohio 43205, USA.
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Völkl-Kernstock S, Bauch-Prater S, Ponocny-Seliger E, Feucht M. Speech and school performance in children with benign partial epilepsy with centro-temporal spikes (BCECTS). Seizure 2009; 18:320-6. [DOI: 10.1016/j.seizure.2008.11.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Revised: 10/21/2008] [Accepted: 11/20/2008] [Indexed: 10/21/2022] Open
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50
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Memory performance on the California Verbal Learning Test of children with benign childhood epilepsy with centrotemporal spikes. Epilepsy Behav 2008; 13:600-6. [PMID: 18655847 DOI: 10.1016/j.yebeh.2008.07.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Revised: 07/07/2008] [Accepted: 07/07/2008] [Indexed: 11/21/2022]
Abstract
Verbal learning and retrieval, as well as the use of learning strategies, were assessed in 24 children with benign epilepsy with centrotemporal spikes (BECTS) and 16 controls, using the California Verbal Learning Test-Children's Version. Neuropsychological data were correlated with EEG features. Compared with age-matched controls, the children with BECTS younger than 10 exhibited significant learning difficulties and were less efficient in using a semantic clustering strategy, whereas no such difference emerged for subjects older than 10. This suggests that the capacity for spontaneous use of a more efficient strategy matures later in children with BECTS. Moreover, the majority of those younger than 10 had multifocal anomalies, suggesting that the difficulties encountered might be caused by the presence of additional foci.
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