Epilepsy and Encephalopathy
Tristan T Sands1, Jennifer N Gelinas1
1Center for Translational Research in Neurodevelopmental Disease, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York; Departments of Neurology and Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.
Insights
Epileptic activity in children can harm brain development, leading to cognitive and behavioral issues. Managing epilepsy focuses on preventing seizures from worsening these developmental outcomes.
Area of Science:
- Pediatric Neurology
- Developmental Neuroscience
- Epileptology
Background:
- Epilepsy involves more than just seizures; it can disrupt normal brain development in children.
- Epileptic activity, both during and between seizures, poses a risk to neurodevelopment.
- Epileptic encephalopathy (EE) describes cognitive and behavioral impairments linked to abnormal brain activity.
Conclusions:
- Preventing the worsening of developmental outcomes by controlling epileptic activity is a key management goal.
- Effective treatments targeting the underlying causes of epilepsy are still needed.
Background:
Epilepsy encompasses more than the predisposition to unprovoked seizures. In children, epileptic activity during (ictal) and between (interictal) seizures has the potential to disrupt normal brain development. The term "epileptic encephalopathy (EE)" refers to the concept that such abnormal activity may contribute to cognitive and behavioral impairments beyond that expected from the underlying cause of the epileptic activity.
Methods:
In this review, we survey the concept of EE across a diverse selection of syndromes to illustrate its broad applicability in pediatric epilepsy. We review experimental evidence that provides mechanistic insights into how epileptic activity has the potential to impact normal brain processes and the development of neural networks. We then discuss opportunities to improve developmental outcomes in epilepsy now and in the future.
Results:
Epileptic activity in the brain poses a threat to normal physiology and brain development.
Conclusion:
Until we have treatments that reliably target and effectively treat the underlying causes of epilepsy, a major goal of management is to prevent epileptic activity from worsening developmental outcomes.
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