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Journal of Pediatric Epilepsy 2018; 07(03): 082-088
DOI: 10.1055/s-0038-1676847
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Effects of Interictal Epileptiform Discharges on Cognition

Joost Meekes
1   Neuropsychology Lab (A7), Department of Psychology, University of Oldenburg, Oldenburg, Germany
,
Aag Jennekens-Schinkel
2   Departments of Child Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center, The Netherlands
› Author Affiliations
Further Information

Publication History

30 April 2018

18 October 2018

Publication Date:
21 December 2018 (online)

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Abstract

Interictal epileptiform discharges (IEDs) are brief events (typically < 1 second, although some authors use a cutoff of up to 3 seconds) in the electroencephalogram (EEG), which are not accompanied by any overt change in behavior or consciousness. IEDs are associated with both chronic cognitive deficits and transient cognitive impairment (TCI). Higher IED load correlates with lower intelligence quotient (IQ) and poorer performance on tests of memory and executive function. TCI has mainly been observed during tasks that place high demands on attention, visuomotor speed, and working memory. There is evidence that IEDs may also directly interfere with episodic memory. Despite the evidence for associations between IEDs and cognitive dysfunction, there is currently scant evidence that IEDs, in fact, cause chronic cognitive deficit in humans. Although causality appears likely in the case of TCI, even here the conditions under which IEDs affect cognition are unclear. The evidence in favor of treating IEDs with medication is very limited. Attempts to treat IEDs should only be made when it is clear that cognitive impairment interferes with activities or participation. Such attempts require strong single-case designs and careful monitoring of both the EEG and cognitive function to establish the efficacy of treatment in individual patients.

Keywords

interictal epileptiform discharges - transient cognitive impairment - nonictiform discharges
 

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