Related Experiment Videos
Transient cognitive impairment during subclinical epileptiform electroencephalographic discharges
1Instituut voor Epilepsiebestrijding, Heemstede, The Netherlands.
Insights
Subclinical epileptiform discharges in children, though unnoticeable, can impair cognition and daily functioning. Valproic acid showed potential in improving cognitive performance by suppressing these electroencephalographic (EEG) discharges.
Area of Science:
- Pediatric Neurology
- Neurophysiology
Background:
- Subclinical epileptiform discharges (SEDs) are brief EEG abnormalities in children, often undetected clinically.
- These SEDs can negatively impact cognitive functions and daily performance in school and home environments.
Purpose of the Study:
- To investigate the cognitive effects of SEDs in children.
- To evaluate the efficacy of valproic acid in suppressing SEDs and improving cognitive function.
Main Methods:
- Review of studies examining the impact of SEDs on cognitive tests (reaction time, memory, academic tasks).
- Analysis of cases where valproic acid was used to suppress EEG discharges and assess cognitive changes.
Main Results:
- SEDs are linked to transient cognitive impairment (TCI), affecting tasks like reading and visual-spatial skills.
- Valproic acid improved cognitive performance in 2 out of 6 children, with limitations due to side effects or incomplete discharge suppression.
Conclusions:
- Individual cases may benefit from suppressing epileptiform EEG discharges.
- Standardized EEG and cognitive measures are crucial for evaluating the effects of SEDs and TCI.
- The phenomenon of TCI should be considered in psychological test evaluations.
Abstract:
Short epileptiform discharges of 10 seconds or less in children with or without epilepsy are not noticed by clinical observation of the child. These so-called subclinical discharges can however disturb cognition and influence daily performance at school and at home. Several studies have been performed to show the negative effect of these epileptiform electroencephalographic (EEG) discharges on choice reaction time tests, short term memory tests (verbal and nonverbal), and on school performance tasks such as reading, writing, and arithmetic. About one-half of children with subclinical discharges will show transient cognitive impairment during these discharges; those with predominantly left-sided discharges are poorer on reading and those with right-sided discharges are poorer on visual spatial tasks. Suppression of the EEG discharges with the antiepileptic drug valproic acid improved cognitive performance in two of six children; failure was because of side effects of the drug or insufficient suppression of the discharges. In individual cases, suppression of the epileptiform EEG discharges can be beneficial. Evaluation of this effect is necessary by standardizing EEG and cognitive performance measures. Furthermore, the phenomenon of transient cognitive impairment (TCI) must be taken into account when evaluating results of psychological tests.