Einfluss interiktaler EEG-Entladungen auf die Kognition

Zsuammenfassung

Interiktale epilepsietypische Potenziale werden als eine der möglichen Gründe für die häufiger ungünstige kognitive Performance von Kindern mit Epilepsie diskutiert. Es werden dabei punktuelle kognitive Defizite, TCI (»transitory cognitive impairment«), von längerfristigen Störungen unterschieden. Letztere können sich bei der Rolando-Epilepsie z. T. durch Aufmerksamkeitsstörungen und Verhaltensveränderungen zeigen, beim Landau-Kleffner-Syndrom durch eine auditive Agnosie und durch einen globalen kognitiven Abbau beim CSWS (kontinuierliche Spike-wave-Aktivität). Entsprechende pathophysiologische Erklärungsmodelle werden aufgezeigt. Therapieempfehlungen zur EEG-Sanierung bestehen beim Landau-Kleffner-Syndrom und CSWS, Therapieversuche zur EEG-Behandlung anfallsfreier Kinder mit weniger auffälligen kognitiven Einbußen zeigen uneinheitliche Ergebnisse. Diese bedürfen derzeit einer Einzelfallentscheidung mit sorgfältiger Dokumentation.

Summary

Interictal epileptiform discharges might be one of the reasons for cognitive impairment of children with epilepsy. Acute, momentary cognitive deficit, known as TCI, is distinguished from more prolonged mental disabilities. The latter can be present in Rolando epilepsy as attention deficit and behavioral disturbance, auditory agnosia in Landau-Kleffner syndrome and gobal mental deterioration in CSWS (continuous spike waves during sleep). Pathophysiological considerations are offered. Recommandations for medical treatment in Landau-Kleffner syndrome and CSWS exists, however the results of therapeutic trials in seizure-free children with interictal epileptiform discharges and only moderate cognitive impairment are still contradictory. A decision for treatment requires an individual view of case with sophisticated documentation.

Schlüsselwörter

Interiktale epilepsietypische Potenziale - Kognition - TCI

Keywords

Interictal epileptic discharges - cognition - TCI

• Literatur

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