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[Continuous localized EEG discharges during sleep in children]
A Pelliccia1, F Galletti, R Pierantoni
1Cattedra di Neuropsichiatria Infantile dell' Università La Sapienza di Roma, Italie.
Insights
Researchers identified a new electroencephalographic (EEG) pattern in children with severe motor and intellectual disabilities. This pattern, characterized by continuous spike-wave discharges during non-rapid eye movement sleep, correlated with brain abnormalities and cognitive impairment.
Area of Science:
- Neurology
- Neurophysiology
- Pediatrics
Context:
- Continuous generalized spike-and-wave complexes during slow-wave sleep were previously reported.
- A new clinical-EEG picture has been observed in children with severe disabilities.
Purpose:
- To describe a novel electroencephalographic (EEG) pattern in children with quadriplegia and hemiplegia.
- To investigate the association between this EEG pattern, brain abnormalities, and cognitive function.
Summary:
- Spike and spike-and-wave complexes localized to one hemisphere were recorded in 6 neurologically impaired children (3 quadriplegic, 3 hemiplegic) during over 85% of non-REM sleep.
- Brain CT revealed midline defects and atrophy in quadriplegic cases, and porencephalic cysts in hemiplegic cases.
- This EEG pattern was linked to more severe mental impairment, with improvement noted when discharges ceased.
Impact:
- Identifies a specific EEG pattern associated with significant neurological deficits in children.
- Suggests a correlation between continuous sleep EEG abnormalities and the severity of cognitive impairment.
- Highlights the potential for monitoring neurological status and treatment response through sleep EEG.
Abstract:
Continuous generalized spike-and-wave complexes occurring during slow-sleep were first observed in some children by Patry et al. (1971). A general review of the reported cases was made by Tassinari et al. (1984). We have observed a new clinical-EEGraphic picture. Spikes and spike-and-wave complexes localized to one hemisphere were recorded during at least 85% non-REM sleep both in 3 quadriplegic and in 3 hemiplegic mentally retarded children, aged from 2 years and 10 months to 11 years (mean age: 5 years and 2 months). Cyclic organization of sleep was almost normal. Wake EEG showed an epileptic focus. Brain CT showed midline defect and brain atrophy in quadriplegic patients, and a wide temporal-parietal porencephalic cyst in hemiplegic patients. This EEGraphic pattern was associated with a more pronounced mental impairment: neuropsychological improvement was observed in 2 cases, when continuous sleep discharges disappeared. As aforesaid, this picture seems to be related either to hemispheric or to midline brain defects. In our cases, sleep phase organization could be examined, while continuous generalized discharges occurring during sleep do not allow such a study.