title: Cognitive effects of interictal epileptiform discharges in children.
abstract: Frequent interictal epileptiform discharges (IEDs) may have effects on cognition. We analysed a group of 182 children with different epilepsy syndromes as well as children with IEDs without observed seizures [corrected], with 24-h ambulatory EEG and cognitive tests. The IED index was estimated, in wakefulness and in sleep, as percentage of time in five categories (0%, <1%, 1-10%, ≥10-50% and ≥50%). IEDs were defined as spikes or spike-wave complexes, isolated or occurring serially (in runs) without evident clinical signs of a seizure. The IED categories were correlated to cognitive test results and epilepsy characteristics. The group of patients with diurnal IEDs in ≥10% of the EEG record showed impaired central information processing speed, short-term verbal memory and visual-motor integration. This effect was seen independently from other EEG-related and epilepsy-related characteristics, and independently from epilepsy syndrome diagnosis. The impact of the nocturnal IEDs was of less importance; only contributing partially to the slowing of central information processing speed. We conclude that frequent IEDs (in more than 10% of the record) in the awake EEG can impair cognitive performance in children. Whether children with a high diurnal spike frequency and low seizure frequency can benefit from antiepileptic treatment should be examined in controlled trials.
authors: Epilepsy Centre Kempenhaeghe, Postbus 61, 5590 AB Heeze, The Netherlands. ebuss@kempenhaeghe.nl
authors: S
authors: S
authors: Ebus
authors: J
authors: J
authors: Arends
authors: J
authors: J
authors: Hendriksen
authors: E
authors: E
authors: van der Horst
authors: N
authors: N
authors: de la Parra
authors: R
authors: R
authors: Hendriksen
authors: E
authors: E
authors: Santegoeds
authors: P
authors: P
authors: Boon
authors: B
authors: B
authors: Aldenkamp
mesh_terms: D002648:Child; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D004522:Educational Status; D004569:Electroencephalography; D004827:Epilepsy / Q000523:psychology*; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D008568:Memory / Q000502:physiology; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology; D012044:Regression Analysis; D012640:Seizures / Q000523:psychology*; D012890:Sleep / Q000502:physiology; D014851:Wakefulness / Q000502:physiology