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Cognitive deterioration and electrical status epilepticus during slow sleep
F B J Scholtes1, M P H Hendriks, W O Renier
1Gemini Hospital, Den Helder, The Netherlands. fscholtes@gemini-ziekenhuis.nl
Epilepsy & Behavior : E&B
|February 16, 2005
Summary
Children with electrical status epilepticus during sleep (ESES) often experience cognitive deterioration unresponsive to medication. Long-duration ESES negatively impacts cognitive recovery, highlighting the need for sleep EEG in diagnosing cognitive decline.
Area of Science:
- Pediatric Neurology
- Neurophysiology
- Cognitive Neuroscience
Background:
- Cognitive deterioration in children can be linked to specific EEG patterns during sleep.
- Electrical status epilepticus during sleep (ESES) is a recognized phenomenon associated with neurological and cognitive impairments.
Purpose of the Study:
- To describe the long-term follow-up of children with cognitive deterioration and ESES.
- To evaluate the efficacy of treatments and the prognosis of cognitive function in these patients.
Main Methods:
- Longitudinal study of 10 children with cognitive deterioration and ESES.
- Repeated neurological and neuropsychological examinations.
- All-night electroencephalography (EEG) to monitor ESES and epileptic activity.
Main Results:
- Seven children had continuous spikes and waves during sleep (CSWS) syndrome, and three had Landau-Kleffner syndrome (LKS).
- Cognitive dysfunction was largely unresponsive to valproate and/or benzodiazepines.
- Only one child showed good cognitive recovery after ESES resolved, with four showing partial recovery.
Conclusions:
- Long-duration ESES and early epileptic activity are associated with an unfavorable cognitive prognosis.
- Cognitive deterioration in children warrants EEG investigation during sleep, even without overt seizures.
- Current therapies for ESES-related cognitive dysfunction show limited efficacy.