Savaş Merve, Tunçer Aylin Müge, Çelik İlayda, Yaşgüçlükal Miray Atacan, Demirbilek Ahmet Veysi, Çokar Ayşe Özlem
İstanbul Atlas University, Faculty of Health Sciences, Department of Speech and Language Therapy, Istanbul, Turkey.
Muğla Sıtkı Koçman University, Faculty of Health Sciences, Department of Speech and Language Therapy, Muğla, Turkey.
Noro Psikiyatr Ars. 2023 Feb 20;60(1):62-67. doi: 10.29399/npa.28086. eCollection 2023.
The electrical status epilepticus in sleep (ESES) accompanies a wide spectrum of focal and generalized epilepsies, which manifest with cognitive-linguistic regression. Both ESES and language impairment can be seen in self-limited focal epileptic syndromes of childhood (SFEC). The association between the presence of ESES pattern on the EEG and the severity of the language impairment has not been adequately clarified.
Twenty-eight SFEC cases without intellectual and motor disabilities and 32 healthy children were recruited. Cases with active ESES (A-ESES, n=6) and without ESES pattern on EEG (non-ESES, n=22) were compared in terms of clinical features and linguistic parameters by both standard and descriptive assessment tools.
The only significantly different clinical feature in the A-ESES group was the increased prevalence of polytherapy. While most of the linguistic parameters were impaired in A-ESES and non-ESES groups compared to healthy controls, A-ESES patients differed from non-ESES patients only in terms of decreased complex sentence production, which was assessed by narrative analysis. A-ESES patients also showed trends toward producing lower numbers of words, nouns, verbs, and adverbs during narrative analysis. There were no differences among patients under polytherapy and monotherapy in terms of these language parameters.
Our results show that ESES increases the negative effect of chronic epilepsy on complex sentence and word production. Linguistic distortions that are not reflected in objective tests can be detected by narrative tools. Complex syntactic production obtained by narrative analysis is an important parameter that extensively characterizes language skills in school-age children with epilepsy.
睡眠期癫痫性电持续状态（ESES）伴随多种局灶性和全身性癫痫发作，表现为认知 - 语言功能倒退。ESES和语言障碍在儿童自限性局灶性癫痫综合征（SFEC）中均可见。脑电图上ESES模式的存在与语言障碍严重程度之间的关联尚未得到充分阐明。
招募了28例无智力和运动障碍的SFEC病例以及32名健康儿童。通过标准和描述性评估工具，对有活动性ESES的病例（A - ESES，n = 6）和脑电图上无ESES模式的病例（非ESES，n = 22）的临床特征和语言参数进行比较。
A - ESES组唯一显著不同的临床特征是联合治疗的患病率增加。与健康对照组相比，A - ESES组和非ESES组的大多数语言参数均受损，但A - ESES患者与非ESES患者仅在复杂句子生成减少方面存在差异，这是通过叙事分析评估的。A - ESES患者在叙事分析中还表现出单词、名词、动词和副词生成数量减少的趋势。联合治疗和单一治疗的患者在这些语言参数方面没有差异。
我们的结果表明，ESES增加了慢性癫痫对复杂句子和单词生成的负面影响。叙事工具可检测到客观测试中未反映的语言扭曲。通过叙事分析获得的复杂句法生成是广泛表征癫痫学龄儿童语言技能的重要参数。
