Siebelink B M, Bakker D J, Binnie C D, Kasteleijn-Nolst Trenité D G
Department of Child Neuropsychology, Free University, Amsterdam, The Netherlands.
Epilepsy Res. 1988 Mar-Apr;2(2):117-21. doi: 10.1016/0920-1211(88)90028-9.
Twenty-one children with suspected or proven epilepsy and subclinical epileptiform EEG discharges in the waking state were studied. The EEG was telemetered and behaviour recorded by closed-circuit television during performance of a general intelligence test (RAKIT, shortened version) which comprised 6 subtests. Mean total IQ was below that of control populations and the subtests profile was abnormal, due particularly to impaired performance on a subtest concerned with verbal short-term memory. This effect was accounted for by that subgroup of children who exhibited discharges during the test; those who did not show discharges at that time were unimpaired. Performance of 3 of the subtests was impaired when discharges occurred during presentation of the test item or between presentation and response. The findings suggest that cognitive impairment found in people with epilepsy may not only represent a more or less static disability, due to drugs, cerebral pathology, etc., but may in part be an intermittent process related to the occurrence of subclinical epileptiform discharges. These preliminary findings need to be amplified but have implications both for interpretation of neuropsychological studies in persons with epilepsy and also for the drug treatment of those who continue to exhibit subclinical EEG discharges when overt seizures have been controlled.
对21名疑似或确诊患有癫痫且在清醒状态下有亚临床癫痫样脑电图放电的儿童进行了研究。在进行一项包括6个子测试的一般智力测试（RAKIT，简化版）期间，通过闭路电视对脑电图进行遥测并记录行为。平均总智商低于对照组人群，子测试结果异常，尤其归因于一项与言语短期记忆有关的子测试表现受损。这种影响是由在测试期间出现放电的儿童亚组造成的；那些在当时未出现放电的儿童未受损害。当在测试项目呈现期间或呈现与回答之间出现放电时，其中3个子测试的表现会受损。研究结果表明，癫痫患者中发现的认知障碍可能不仅代表由于药物、脑部病变等导致的或多或少的静态残疾，而且部分可能是与亚临床癫痫样放电的发生相关的间歇性过程。这些初步发现需要进一步充实，但对癫痫患者神经心理学研究的解释以及对那些在明显癫痫发作得到控制后仍有亚临床脑电图放电的患者的药物治疗都有影响。
