Benign childhood epilepsy with Centro-Temporal spikes (BCECTSs), electrical status epilepticus in sleep (ESES), and academic decline - How aggressive should we be?

被引:24
作者
Uliel-Sibony, Shimrit [1 ]
Kramer, Uri [1 ]
机构
[1] Tel Aviv Univ, Tel Aviv Sourasky Med Ctr, Pediat Neurol Unit, IL-69978 Tel Aviv, Israel
关键词
BCECTS; SES; Academic decline; Treatment; SLOW SLEEP; CENTROTEMPORAL SPIKES; ROLANDIC EPILEPSY; CHILDREN; EEG; ENCEPHALOPATHY; WAVES; SEIZURES; LEVETIRACETAM; DISORDERS;
D O I
10.1016/j.yebeh.2015.01.004
中图分类号
B84 [心理学]; C [社会科学总论]; Q98 [人类学];
学科分类号
03 ; 0303 ; 030303 ; 04 ; 0402 ;
摘要
Since many of the children with BCECTSs display electrical status epilepticus during sleep and many present with different comorbidities, mainly ADHD and behavioral disturbances, clinicians are often confronted with the dilemma of how aggressive they should be with their efforts of normalizing the EEG. We conducted a retrospective study by screening medical records of all consecutive patients with BCECTSs, spike-wave index (SWI) >30%, and ADHD/ADD that were evaluated in our pediatric epilepsy service and were followed up for at least two years. Patients with neurocognitive deterioration detected by formal testing were excluded. A total of 17 patients with mean age of 6.9 years at BCECTS diagnosis were identified. The patients' mean SWI was 60% and that dense electrical activity lasted 1.5 years on average (range: 1-4.5 years). Six children were formally diagnosed with learning disabilities in addition to ADD/ADHD. All of them were treated with an average of three antiepileptic medications, mainly for the purpose of normalizing the EEG, but none of them was treated with steroids or high-dose diazepam. The mean duration of follow-up was 5.5 years. A cognitive or behavioral deterioration was not detected in any of them. Our data suggest that when treating a child with BCECTSs, high SWI, and school difficulties, the most critical parameter that determines the necessity of using second-line antiepileptic agents such as steroids or high-dose diazepam is a formal psychological evaluation that proves cognitive (I.Q.) decline. Otherwise, these agents may be avoided. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:117 / 120
页数:4
相关论文
共 42 条
[1]   Levetiracetam efficacy in epileptic syndromes with continuous spikes and waves during slow sleep: Experience in 12 cases [J].
Aeby, A ;
Poznanski, N ;
Verheulpen, D ;
Wetzburger, C ;
Van Bogaert, P .
EPILEPSIA, 2005, 46 (12) :1937-1942
[2]  
Aicardi J, 1987, INT PEDIATR, V2, P176
[3]  
[Anonymous], EPILEPTIC SYNDROMES
[4]  
BILLARD C, 1982, SLEEP EPILEPSY, P481
[5]   CONTINUOUS SPIKES AND WAVES DURING SLOW SLEEP - A 30 MONTHS FOLLOW-UP-STUDY OF NEUROPSYCHOLOGICAL RECOVERY AND EEG FINDINGS [J].
BOEL, M ;
CASAER, P .
NEUROPEDIATRICS, 1989, 20 (03) :176-180
[6]   Efficacy of levetiracetam in pharmacoresistant continuous spikes and waves during slow sleep [J].
Capovilla, G ;
Beccaria, F ;
Cagdas, S ;
Montagnini, A ;
Segala, R ;
Paganelli, D .
ACTA NEUROLOGICA SCANDINAVICA, 2004, 110 (03) :144-147
[7]  
Dalla Bernardina B, 1989, ADV EPILEPTOL, VXVII, P295
[8]   Benign epilepsy of childhood with rolandic spikes: Typical and atypical variantsE [J].
Datta, Anita ;
Sinclair, D. Barry .
PEDIATRIC NEUROLOGY, 2007, 36 (03) :141-145
[9]   TREATMENT OF ELECTRICAL STATUS EPILEPTICUS BY SHORT DIAZEPAM (DZP) CYCLES AFTER DZP RECTAL BOLUS TEST [J].
DENEGRI, M ;
BAGLIETTO, MG ;
BATTAGLIA, FM ;
GAGGERO, R ;
PESSAGNO, A ;
RECANATI, L .
BRAIN & DEVELOPMENT, 1995, 17 (05) :330-333
[10]   Benign partial epilepsy of childhood: a longitudinal neuropsychological and EEG study off cognitive function [J].
Deonna, T ;
Zesiger, P ;
Davidoff, V ;
Maeder, M ;
Mayor, C ;
Roulet, E .
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, 2000, 42 (09) :595-603