Abstract
Abstract 1 D. Kasteleijn-Nolst Trenité ( 1 University La Sapienza (Rome), Italy and University of Utrecht, Netherlands ) Epileptic activity can disturb cognition even when no clinical signs or symptoms are present. These short-lasting discharges of 10 seconds or less are called subclinical EEG-discharges and can occur during sleep or wakefulness. Not only are these discharges an expression of underlying brain dysfunction, but also they have themselves a negative effect on performance of tasks. Since 1939 research has been undertaken to unravel the impact of these subclinical discharges, either isolated and focal or long-lasting and generalised. It is by far easier to determine the direct impact of short lasting epileptiform discharges on cognition when the patient is awake than when asleep and most studies were performed even during evoked epileptiform discharges using hyperventilation or photic stimulation. The more complex the task, the more disturbance can be found. Individual differences are important and interaction between performance of the task and occurrence of epileptiform discharges complicates matters further. Much more recently long-term follow-up studies have been undertaken in patients with rolandic and occipital epilepsy and those with epileptic activity during sleep to determine their cognitive evolution. Mainly transient deficits were found and these appeared to be correlated in time with worsening of the EEG in the active phase Besides scientific purposes, insight into the various factors involved in cognitive impairment in patients with subclinical EEG-discharges is of practical importance. Grant: European Cie–Marie Curie Actions.
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