The aim of this study is to evaluate cognitive development globally and by single functions in patients with high activation and diffusion of focal spikes during sleep. We studied 8 patients, aged 6 years 2 months to 13 years 6 months, affected by a partial epilepsy (PE) (4 benign and 4 cryptogenetic PE), with focal or multifocal spikes during waking. These patients underwent the P' cycle slow sleep EEG study, which showed an wide diffusion of these abnormalities (30.9% to 9()<7r of the slow sleep duration). These patients were evaluated using the WISC-R scale. 10 months (range, 1-32 months) after the evidence of sleep EEG activation. Some patients underwent other tests to complete and verify W1SC results: Raven coloured progressive matrices. Rey copy and memory, attention test, and Rey verbal memory. The results were treated according to Kautman's factorial model. Results Global IQ was within normal range in 7 patients, in the eighth we observed a deterioration of global 1Q from borderline to severe mental retardation; there was no difference in results between benign and cryptogenetic PE. A significant deficit of performance versus verbal 1Q (/xO.05) was seen in 3 of 8 patients. A significant deficit of perceptive versus verbal organisation (/xO.Ol) was found in 2 patients. A significant deficit (/xO.Ol) of concentration (memory and attention) versus verbal comprehension was seen in 4 of 8 and versus perceptive organisation in 4 of 8 patients. The repetition of cognitive tests, made in 2 patients when diffused SW disappeared, showed an amelioration of results; in a third patient 2 tests performed during EEG status showed a non-significant worsening in concentration. These data suggest that the presence of this particular sleep pattern (diffusion and activation of epileptic anomalies), even if not so important as the ESES profile, may indicate a significant disorder of child cognitive development. The functions most significantly involved are: concentration and perceptive organisation versus verbal comprehension. Attention to these difficulties and a prompt rehabilitation in these patients may improve school achievements, which are not alwaysjudged satisfactory by parents and teachers.
Cognitive development in patients with high activation of spikes during sleep
BASSI, Bianca;
1999-01-01
Abstract
The aim of this study is to evaluate cognitive development globally and by single functions in patients with high activation and diffusion of focal spikes during sleep. We studied 8 patients, aged 6 years 2 months to 13 years 6 months, affected by a partial epilepsy (PE) (4 benign and 4 cryptogenetic PE), with focal or multifocal spikes during waking. These patients underwent the P' cycle slow sleep EEG study, which showed an wide diffusion of these abnormalities (30.9% to 9()<7r of the slow sleep duration). These patients were evaluated using the WISC-R scale. 10 months (range, 1-32 months) after the evidence of sleep EEG activation. Some patients underwent other tests to complete and verify W1SC results: Raven coloured progressive matrices. Rey copy and memory, attention test, and Rey verbal memory. The results were treated according to Kautman's factorial model. Results Global IQ was within normal range in 7 patients, in the eighth we observed a deterioration of global 1Q from borderline to severe mental retardation; there was no difference in results between benign and cryptogenetic PE. A significant deficit of performance versus verbal 1Q (/xO.05) was seen in 3 of 8 patients. A significant deficit of perceptive versus verbal organisation (/xO.Ol) was found in 2 patients. A significant deficit (/xO.Ol) of concentration (memory and attention) versus verbal comprehension was seen in 4 of 8 and versus perceptive organisation in 4 of 8 patients. The repetition of cognitive tests, made in 2 patients when diffused SW disappeared, showed an amelioration of results; in a third patient 2 tests performed during EEG status showed a non-significant worsening in concentration. These data suggest that the presence of this particular sleep pattern (diffusion and activation of epileptic anomalies), even if not so important as the ESES profile, may indicate a significant disorder of child cognitive development. The functions most significantly involved are: concentration and perceptive organisation versus verbal comprehension. Attention to these difficulties and a prompt rehabilitation in these patients may improve school achievements, which are not alwaysjudged satisfactory by parents and teachers.
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