Kasteleijn-Nolst Trenité D G
Instituut voor Epilepsiebestrijding, Heemstede, The Netherlands.
Semin Pediatr Neurol. 1995 Dec;2(4):246-53. doi: 10.1016/s1071-9091(95)80003-4.
Short epileptiform discharges of 10 seconds or less in children with or without epilepsy are not noticed by clinical observation of the child. These so-called subclinical discharges can however disturb cognition and influence daily performance at school and at home. Several studies have been performed to show the negative effect of these epileptiform electroencephalographic (EEG) discharges on choice reaction time tests, short term memory tests (verbal and nonverbal), and on school performance tasks such as reading, writing, and arithmetic. About one-half of children with subclinical discharges will show transient cognitive impairment during these discharges; those with predominantly left-sided discharges are poorer on reading and those with right-sided discharges are poorer on visual spatial tasks. Suppression of the EEG discharges with the antiepileptic drug valproic acid improved cognitive performance in two of six children; failure was because of side effects of the drug or insufficient suppression of the discharges. In individual cases, suppression of the epileptiform EEG discharges can be beneficial. Evaluation of this effect is necessary by standardizing EEG and cognitive performance measures. Furthermore, the phenomenon of transient cognitive impairment (TCI) must be taken into account when evaluating results of psychological tests.
癫痫样放电持续时间在10秒及以内的儿童，无论是否患有癫痫，通过对儿童的临床观察都无法察觉。然而，这些所谓的亚临床放电会干扰认知，并影响儿童在学校和家中的日常表现。已有多项研究表明，这些癫痫样脑电图（EEG）放电对选择反应时间测试、短期记忆测试（语言和非语言）以及阅读、写作和算术等学校表现任务具有负面影响。约一半有亚临床放电的儿童在放电期间会出现短暂的认知障碍；主要为左侧放电的儿童在阅读方面表现较差，而右侧放电的儿童在视觉空间任务方面表现较差。使用抗癫痫药物丙戊酸抑制EEG放电后，六名儿童中有两名的认知表现得到改善；未能改善的原因是药物副作用或放电抑制不足。在个别情况下，抑制癫痫样EEG放电可能有益。有必要通过标准化EEG和认知表现测量方法来评估这种效果。此外，在评估心理测试结果时，必须考虑短暂认知障碍（TCI）现象。
