REVIEW Cognitive functions and epileptic activity

Abstract

Epilepsy, and its treatment, can affect the development and use of language in a number of different ways. The seizures may be a symptom of a lesion in areas of the brain essential for language function, and the complications of both the seizures and of the drugs can interfere with learning. However, the purpose of this review is to consider the role of epileptic activity as demonstrated by electrical discharges in the electroencephalogram (EEG), whether these are accompanied by overt seizures or not, on cerebral function especially that of language. The Landau-Kleffner, the continuous spike-waves during sleep, and the benign epilepsy of childhood with Rolandic spikes syndromes are considered; as well as the evidence of epileptic discharges affecting language development. If there are doubts that a patient is suffering from epilepsy the diagnosis may be difficult; and anyone involved in the treatment of language disorders should keep this possibility in mind. Particularly during childhood an EEG, awake and asleep, should be an important part of the assessment of both developmental and acquired dysphasia. The control of overt fits may be relatively easy, but drugs are not so effective in controlling the epileptic activity in the EEG. The treatment of such discharges used to be discouraged, but the evidence is now strongly in favour of employing both medical and surgical treatment. The results in restoring language function are sometimes dramatic.

Outcome after prolonged convulsive seizures in 186 children: low morbidity, no mortality

“…Cognitive or behavioural outcomes were not assessed by routine neuropsychological tests in this study, and the cognitive problems were observed only on an individual basis. This, however, would be an interesting subject for further studies in these children because it is known that epileptic activity can have various effects on cognitive functions (Deonna 2000, Gordon 2000.…”

Cognitive Effects of “Older” Anticonvulsants in Children with Epilepsy: A Review and Critique of the Literature

“…8 Epileptic syndromes characterized by severe, intractable seizure activity such as Lennox Gastaut Syndrome are also associated with a high risk of cognitive decline. 9,10 In contrast, children that experience simple febrile seizures, benign Rolandic epilepsy, juvenile myoclonic epilepsy, and childhood and juvenile absence epilepsy generally have normal intellectual functioning. 8 As stated before, a wide variety of cognitive profiles are found in children with epilepsy.…”

Neurocognitive functioning of preschool children with uncomplicated epilepsy

“…Language development may be adversely affected by epileptic activity (Gordon, 2000). An association between epileptic activity and language development is demonstrated in children with benign childhood epilepsy with focal spikes (Monjauze, Tuller, Hommet, Barthez, & Khomsi, 2005; Svoboda, 2004).…”

“…It is possible that electrophysiological epileptic activity, seizures, and/or antiepileptic medication at that time especially may interfere with language development, which is active at that age period. Gordon (2000) emphasized the importance of the association between epileptic activity and language especially in small children, but not all studies (Monjauze et al , 2005) found a correlation between age at seizure onset and language performance. With respect to seizure type, Mandelbaum and Burack (1997) found that on cognitive functioning children with focal seizures performed better than children with generalized seizures.…”