[The effect of interictal epileptiform discharges on cognitive function in children with idiopathic epilepsy]. / Efecto de las descargas epileptiformes interictales sobre las funciones cognitivas en niños con epilepsia idiopática.

INTRODUCTION: Transient cognitive disorders (CD) in benign rolandic epilepsy (BRE), the most common of idiopathic partial epilepsy (IPE), may be secondary to interictal epileptiform discharges (IED). OBJECTIVES: To determine incidence and risk factors for persistent TC in students with IE before, during and after antiepileptic (AE). INCLUSION CRITERIA: 6 12 years old, IPE, controlled for 2 years with AE, and follow up for 5 years. EVALUATIONS: intelligence (Wechsler III), learning (Wechsler), academic level (Woodcock Johnson) and attention/behavior (O Conners R). VARIABLES: sex, age of onset, seizure type, interval between first seizure and AE onset, EEG results and AE type. ANALYSIS: chi square. RESULTS: Fourteen children had decreased learning and attention span with impulsivity, hyperactivity, low tolerance and agressivity during remission; 12 (85,71%) with temporal lobe epilepsy: 6 (50%) with IED in the left dominant hemisphere, 2 (16,67%) with IED in the right temporal lobe in left dominant hemisphere children, 2 (16,67%) in both temporal lobes in left dominant hemisphere children and 2 (14,29%) with ERB and IED. MRI were normal. CONCLUSIONS: Children with idiopathic temporal lobe epilepsy and IED in the left dominant hemisphere are at higher risk for CD than children with other types of IPE. To control the seizures and to abolish the IED are recommended in an attempt to prevent these cognitive disorders

Efecto de las descargas epileptiformes interictales sobre las funciones cognitivas en niños con epilepsia idiopática / The effect of interictal epileptiform discharges on cognitive function in children with idiopathic epilepsy

Introducción. Los trastornos cognitivos (TC) transitorios en niños con epilepsia rolándica benigna (ERB), la más común de las epilepsias parciales idiopáticas (EPI), son secundarios a descargas epileptiformes interictales (DEI). Objetivos. Determinar la incidencia y factores de riesgo de los TC persistentes en escolares con EPI antes, durante y después de la administración de antiepilépticos (AE). Pacientes y métodos. Criterio de inclusión: edad de 6 a 12 años, EPI, control con AE durante dos 2 años y seguimiento durante cinco años. Evaluaciones: inteligencia (Wechsler-III), aprendizaje (Wechsler), nivel académico (Woodcock-Johnson) y atención/conducta (O'Conners-R). Variables: sexo, edad de comienzo, tipo de EPI, intervalo entre la primera crisis y comienzo del AE, resultado del EEG y tipo de AE. Análisis: ji cuadrado. Resultados. No se observaron TC antes de comenzar los AE ni durante los dos años con AE y sin crisis clínicas ni EEG. 14 pacientes tuvieron trastornos del aprendizaje, inatención, impulsividad, hiperactividad, baja tolerancia y agresividad durante la remisión; 12 (85,71 por ciento) con epilepsia del lóbulo temporal: seis (50 por ciento) con DEI en el lado izquierdo (hemisferio dominante izquierdo), dos (16,67 por ciento) con DEI en el derecho (hemisferio dominante izquierdo), dos (16,67 por ciento) en ambos lóbulos temporales y dos (14,29 por ciento) con ERB. La resonancia magnética cerebral fue normal. Conclusiones. Los niños con epilepsia del lóbulo temporal idiopática con DEI en el hemisferio dominante presentan mayor riesgo que el resto de los pacientes con EPI a sufrir TC. Se recomienda eliminar no sólo las cisis, sino también las DEI, para evitar estos trastornos (AU)

Introduction. Transient cognitive disorders (CD) in benign rolandic epilepsy (BRE), the most common of idiopathic partial epilepsy (IPE), may be secondary to interictal epileptiform discharges (IED). Objectives. To determine incidence and risk factors for persistent TC in students with IE before, during and after antiepileptic (AE). Patients and methods. Inclusion criteria: 6-12 years old, IPE, controlled for 2 years with AE, and follow-up for 5 years. Evaluations: intelligence (Wechsler-III), learning (Wechsler), academic level (Woodcock-Johnson) and attention/behavior (O’Conners-R). Variables: sex, age of onset, seizure type, interval between first seizure and AE onset, EEG results and AE type. Analysis: chi square. Results. Fourteen children had decreased learning and attention span with impulsivity, hyperactivity, low tolerance and agressivity during remission; 12 (85,71%) with temporal lobe epilepsy: 6 (50%) with IED in the left dominant hemisphere, 2 (16,67%) with IED in the right temporal lobe in left dominant hemisphere children, 2 (16,67%) in both temporal lobes in left dominant hemisphere children and 2 (14,29%) with ERB and IED. MRI were normal. Conclusions. Children with idiopathic temporal lobe epilepsy and IED in the left dominant hemisphere are at higher risk for CD than children with other types of IPE. To control the seizures and to abolish the IED are recommended in an attempt to prevent these cognitive disorders (AU)