Neuropsychological Deficits in Patients with Electrical Status Epilepticus During Sleep: A Non-invasive Analysis of...

To evaluate the effects of electrical status epilepticus during sleep (ESES) on cerebral blood flow (CBF) and explore the associated neuro-vascular coupling and neuropsychological deficits. 19 ESES patients were recruited to undergo real-time transcranial doppler ultrasonography (TCD) and video-EEG monitoring (vEEG). Patients were grouped based on their cognitive functions or their EEG patterns. The mean cerebral blood flow velocity (CBFV_m) of the unilateral middle cerebral artery was measured using TCD and was used to calculate various relevant parameters. The 19 patients participated in a total of 54 effective TCD-vEEG monitoring sessions. We found a significant effect of clinical severity for the following measurements: spike wave index (SWI), peak and average deep sleep stage (N3) CBFV_m, peak, average and minimum deep sleep and awake CBFV_m, and CBFV_m oscillations during deep sleep. Nevertheless, CBFV_m oscillations were not related to SWI. Furthermore, CBFV_m oscillations revealed a statistically significant difference between the near-ESES and asymmetric-ESES groups. CBFV_m oscillations may reflect the neuro-vascular coupling process associated with ESES disfunction. Understanding the relationship between CBFV_m oscillations and epileptic activity will be important for assessing the neuropsychological damage associated with ESES and for developing treatment options for this and other diseases.