Neuropsychological alterations are frequent in rolandic epilepsy and its atypical developments
*Correspondencia: Dra. Gabriela Pesántez Ríos. Centro Nacional de Epilepsia. José Berrueta. CP 170129. Quito, Ecuador.
E-mail: gabriela.pesantez@gmail.com
Introduction. Rolandic epilepsy or benign childhood epilepsy with centrotemporal spikes is called benign because its seizures are usually favourable and due to the spontaneous normalisation of the electroencephalogram on reaching puberty. Nevertheless, evidence has been found of the impact on cognitive development with the presence of heterogeneous cognitive deficits, especially related to persistent intercritical discharges during non-REM sleep. The aim of this study is to examine the epileptogenic networks involved in the neuropsychological disorders of this pathology.
Development. A common feature of the atypical developments is persistent epileptic activity during slow sleep, which plays an important role in the development of the neurocognitive deficits that are associated to this pathology. Factors such as the age at onset of the epilepsy, the onset of the atypical development, the location of the interictal discharges and the continuous epileptic activity during sleep that persists for more than two years can trigger changes in the functioning of the neurocognitive networks. This may result in deficits in the neuropsychological functions, which may
even be irreversible.
Conclusions. A close clinical and electroencephalographic follow-up is necessary. Moreover, formal neuropsychological studies must be conducted as of the onset of benign childhood epilepsy with centrotemporal spikes. This is even more necessary in cases in which there is an obvious atypical development in order to detect and prevent the neuropsychological deficits before they establish themselves on a definitive basis.
Desarrollo Las evoluciones atípicas tienen en común una actividad epiléptica persistente durante el sueño lento, que desempeña un papel importante en el desarrollo de los déficits neurocognitivos que se asocian a esta patología. Factores como la edad de inicio de la epilepsia, el inicio de la evolución atípica, la localización de las descargas interictales y la actividad epiléptica continua durante el sueño que persista durante más de dos años pueden provocar cambios en el funcionamiento de las redes neurocognitivas, con los consecuentes déficits en las funciones neuropsicológicas, que incluso pueden resultar irreversibles.
Conclusiones Es necesario un seguimiento cercano tanto clínico como electroencefalográfico; además, deben realizarse estudios neuropsicológicos formales desde el inicio de la epilepsia benigna de la infancia con puntas centrotemporales y más en los casos que es evidente una evolución atípica para detectar y prevenir los déficits neuropsicológicos antes de que se instauren definitivamente.