Laboratoire de cartographie fonctionnelle du cerveau (LCFC), Erasme hospital, université libre de Bruxelles (ULB), Brussels, Belgium.
Neurophysiol Clin. 2012 Jan-Feb;42(1-2):53-8. doi: 10.1016/j.neucli.2011.11.004. Epub 2011 Nov 29.
It is hypothesised that focal interictal epileptiform discharges (IED) may exert a deleterious effect on behaviour and cognition in children. This hypothesis is supported by the abnormally high prevalence of IED in several developmental disorders, like specific language impairment, and of cognitive and behavioural deficits in epileptic children after excluding confounding factors such as underlying structural brain lesions, drug effects, or the occurrence of frequent or prolonged epileptic seizures. Neurophysiological and functional neuroimaging evidence suggests that IED may impact cognition through either transient effects on brain processing mechanisms, or through more long-lasting effects leading to prolonged inhibition of brain areas distant from but connected with the epileptic focus (i.e. remote inhibition effect). Sustained IED may also impair sleep-related learning consolidation processes. Nowadays, the benefits of anti-epileptic treatment aimed at reducing IED are not established except in specific situations like epileptic encephalopathies with continuous spike and waves during slow-wave sleep. Well-designed pharmacological studies are still necessary to address this issue.
人们假设局灶性癫痫间放电（IED）可能对儿童的行为和认知产生有害影响。这一假设得到了以下事实的支持：在几种发育障碍中，如特定语言障碍，IED 的发病率异常高，以及在排除了潜在的结构性脑损伤、药物作用或频繁或长时间癫痫发作等混杂因素后，癫痫儿童存在认知和行为缺陷。神经生理学和功能神经影像学证据表明，IED 可能通过对大脑处理机制的短暂影响，或者通过更持久的影响导致远离但与癫痫灶相连的大脑区域的长时间抑制（即远程抑制效应）来影响认知。持续的 IED 也可能损害与睡眠相关的学习巩固过程。如今，除了在癫痫性脑病等特定情况下，如慢波睡眠期间持续棘慢波，旨在减少 IED 的抗癫痫治疗的益处尚未得到证实。仍需要精心设计的药理学研究来解决这个问题。
