Reciprocal interactions between epileptogenic zone and maturating cortex in children

Autor: Delphine Taussig, Sarah Ferrand-Sorbets, Martine Fohlen, Mathilde Chipaux, Georg Dorfmüller, Nathalie Dorison, Olivier Bekaert
Rok vydání: 2018
Předmět:
Zdroj: Neurophysiologie Clinique. 48:225-226
ISSN: 0987-7053
DOI: 10.1016/j.neucli.2018.06.017
Popis: Objectives Epilepsy in children can be devastating as it interferes with cortical maturation. Consequences could both disturb cognitive functions and create antiepileptic drugs resistance. Reciprocal interactions between epileptogenic zone and maturating cortex in children were analyzed through stereo EEG data. Methods Characteristics of neurophysiological and clinical data in focal drug-resistant epilepsy in children were analyzed both in Rothschild Foundation series and in the literature and were compared to adult data to highlight differences. We also try to find out reciprocal interactions between epileptogenic zone and maturating cortex. Results Younger children have often huge cortical lesions containing more than one epileptic zone. These regional multifocal foci could cause multiple types of seizures. The diffusion of abnormalities from the epileptogenic zone is wider than in the adult population and causes disruptions in the adjacent and also remote functional cortex. Focal pediatric epilepsy can evolve in acute worsening as prolonged status epilepticus with permanent activation of the focus, which is quite rare in adult population. Moreover, the extension of the epileptogenic zone can vary with age in the same patient and lead to appearance of new types of seizures, event after cortical resection. Surprisingly, we show that the posterior-anterior maturational gradient has no impact on the activation of epileptogenic zone. And finally, as the child is getting older, he can explain his subjective symptoms and electro-clinical correlations allow to better delineate the epileptogenic zone. Conclusion Epileptogenic zone can be multiple in children, even in surgical candidates, but electro-clinical correlations are still possible, even in younger children. Reciprocal interactions between epileptogenic zone and maturating cortex in children lead to worsen both epilepsy and cognitive development. When possible, cortical resection or disconnection should then be discussed as soon as possible in pediatric population.
Databáze: OpenAIRE
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