Henkin Yael, Kishon-Rabin Liat, Pratt Hillel, Kivity Sara, Sadeh Michelle, Gadoth Natan
Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Epilepsia. 2003 Sep;44(9):1207-17. doi: 10.1046/j.1528-1157.2003.65402.x.
Auditory processing of increasing acoustic and linguistic complexity was assessed in children with idiopathic generalized epilepsy (IGE) by using auditory event-related potentials (AERPs) as well as reaction time and performance accuracy.
Twenty-four children with IGE [12 with generalized tonic-clonic seizures (GTCSs), and 12 with absence seizures (ASs)] with average intelligence and age-appropriate scholastic skills, uniformly medicated with valproic acid (VPA), and 20 healthy controls, performed oddball discrimination tasks that consisted of the following stimuli: (a) pure tones; (b) nonmeaningful monosyllables that differed by their phonetic features (i.e., phonetic stimuli); and (c) meaningful monosyllabic words from two semantic categories (i.e., semantic stimuli).
AERPs elicited by nonlinguistic stimuli were similar in healthy and epilepsy children, whereas those elicited by linguistic stimuli (i.e., phonetic and semantic) differed significantly in latency, amplitude, and scalp distribution. In children with GTCSs, phonetic and semantic processing were characterized by slower processing time, manifested by prolonged N2 and P3 latencies during phonetic processing, and prolongation of all AERPs latencies during semantic processing. In children with ASs, phonetic and semantic processing were characterized by increased allocation of attentional resources, manifested by enhanced N2 amplitudes. Semantic processing also was characterized by prolonged P3 latency. In both patient groups, processing of linguistic stimuli resulted in different patterns of brain-activity lateralization compared with that in healthy controls. Reaction time and performance accuracy did not differ among the study groups.
AERPs exposed linguistic-processing deficits related to seizure type in children with IGE. Neurologic follow-up should therefore include evaluation of linguistic functions, and remedial intervention should be provided, accordingly.
通过使用听觉事件相关电位（AERP）以及反应时间和表现准确性，评估特发性全身性癫痫（IGE）儿童对声音和语言复杂性增加的听觉处理能力。
24名平均智力和学业技能符合年龄的IGE儿童[12名全身性强直阵挛发作（GTCS）患儿和12名失神发作（AS）患儿]，均接受丙戊酸（VPA）治疗，以及20名健康对照者，进行了奇偶数辨别任务，该任务由以下刺激组成：（a）纯音；（b）根据语音特征不同的无意义单音节（即语音刺激）；以及（c）来自两个语义类别的有意义单音节词（即语义刺激）。
非语言刺激诱发的AERP在健康儿童和癫痫儿童中相似，而语言刺激（即语音和语义）诱发的AERP在潜伏期、波幅和头皮分布上有显著差异。在GTCS患儿中，语音和语义处理的特点是处理时间较慢，表现为语音处理期间N2和P3潜伏期延长，以及语义处理期间所有AERP潜伏期延长。在AS患儿中，语音和语义处理的特点是注意力资源分配增加，表现为N2波幅增强。语义处理的特点还包括P3潜伏期延长。在两个患者组中，与健康对照者相比，语言刺激处理导致不同的脑活动侧化模式。研究组之间的反应时间和表现准确性没有差异。
AERP揭示了IGE儿童与癫痫发作类型相关的语言处理缺陷。因此，神经学随访应包括语言功能评估，并相应地提供补救干预。
