A follow-up study in children with status epilepticus during sleep: From clinical spectrum to outcome
Bing-Wei Peng1, Hai-Xia Zhu1, Xiu-Ying Wang1
1Department of Neurology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, China.
Insights
Classifying children with sleep epilepsy syndromes (SES) is crucial for predicting outcomes. The specific epilepsy type significantly impacts both cognitive deficits and treatment success in pediatric patients.
Area of Science:
- Pediatric Neurology
- Epileptology
- Neurodevelopmental Disorders
Background:
- Sleep epilepsy syndromes (SES) encompass a range of conditions affecting children.
- Understanding the relationship between epilepsy type, cognitive function, and treatment response is vital for effective management.
Purpose of the Study:
- To investigate the correlation between the clinical spectrum of epilepsy syndromes in children with SES.
- To evaluate the impact of these syndromes on neuropsychological deficits and therapeutic outcomes.
Main Methods:
- Categorized 39 children with SES into four epilepsy syndromes: SEBECTs, ABFEC, NIFE, and LKS.
- Assessed neuropsychological status (DD/ID, CI, AHD, NG) and therapeutic outcomes (satisfactory, recurrence, seizure control).
Main Results:
- Neuropsychological outcomes significantly varied across epilepsy syndromes (P < 0.001), with deficits common in ABFEC and NIFE.
- Therapeutic outcomes also differed significantly by syndrome (P = 0.041), with NIFE showing the poorest response.
- Focal cortical dysplasia (FCD) was noted in some NIFE cases, impacting outcomes.
Conclusions:
- Categorizing pediatric SES into specific epilepsy syndromes is essential.
- The clinical spectrum of SES is a significant determinant of neuropsychological deficits and therapeutic outcomes.
Purpose:
To evaluate the correlation between clinical spectrum and therapeutic outcomes and neuropsychological deficits in children with status epilepticus during sleep (SES).
Methods:
The clinical spectrum of patients with SES was defined as follows: status epilepticus of benign childhood epilepsy with centro-temporal spikes (SEBECTs), atypical benign focal epilepsy during childhood (ABFEC), non-idiopathic focal epilepsy (NIFE), and Landau-Kleffner syndrome (LKS). SES cases were divided into 4 groups according to neuropsychological findings before treatment: developmental delay/intellectual disability (DD/ID), cognitive impairment (CI), attention deficit and/or hyperactivity behaviors (AHD), and normal group (NG). The therapeutic outcomes were classified into 3 groups: satisfactory response, recurrence, and seizure control.
Results:
A total of 39 cases (24 males and 15 females) were recruited, including 3 cases with SEBECTs, 26 with ABFEC, 8 with NIFE [2 with focal cortical dysplasia (FCD)], and 2 with LKS. There were 7 patients in the DD/ID group, 8 in the CI group, 19 in the AHD group, and 5 in the NG group. Neuropsychological outcomes were significantly different among clinical spectrum (P < 0.001), and neuropsychological deficits frequently occurred in the ABFEC group or in the NIFE group. Besides, 18 patients in the satisfactory group had satisfactory response to medicine or surgery (2 out of 18 cases with FCD), whereas recurrence was observed at least one session within one year in 16 cases in the recurrence group, and no improvement in spike-wave index and cognition/behavior was noted in 5 patients in the seizure control group, although seizure could be controlled. There were significant differences in therapeutic outcomes among clinical spectrum (P = 0.041), with the worst outcomes in the NIFE group (only 1 out of 8 with satisfactory good response).
Conclusions:
It is important to categorize patients with SES into epilepsy syndromes, including SEBECTs, ABFPEC, NIFE, and LKS; the clinical spectrum may be a significant determinant to influence the outcomes of SES, including neuropsychological deficits and therapeutic outcomes.
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