Glória Maria Almeida Souza Tedrus

Epileptiform EEG discharges in benign childhood epilepsy with centrotemporal spikes: Reactivity and transitory cognitive impairment

The reactivity of rolandic spikes (RS) and the occurrence of transitory cognitive impairment (TCI) during RSs were assessed in 33 children with benign childhood epilepsy with centrotemporal spikes (BECTS). The children were assessed simultaneously with EEG and computerized neuropsychological testing in a visual discrimination between words and pseudowords task (DWPT). In 20 (60.6%) children, there were insufficient RS to assess the occurrence of TCI. Of 13 children with RS between stimulus presentation and response, only 2 (15.4%) made a significantly greater proportion of errors during RS than during RS-free periods, characterizing the occurrence of TCI. The RS appear to be easily inhibited by the DWPT. TCI occurred in a limited number of cases and did not impair school performance. There is a need to study other tasks and search for other factors influencing cognitive abilities in children with BECTS.

Dementia, mild cognitive impairment and quantitative EEG in patients with Parkinson's disease.

The objective of this study was to evaluate relationships between quantitative EEG (qEEG) changes and cognitive disturbance (mild cognitive impairment or dementia) and the motor disturbance stage in Parkinsons disease (PD). Thirty-two PD patients (age=67.2±10.0) and 26 normal subjects (age=68.4±4.7) were assessed using a neurological evaluation, modified Hoehn and Yahr (HY) scale for PD, a Portuguese version of the CERAD neuropsychological battery (consortium to establish a registry for Alzheimers disease) incorporating the Mini-mental Status Examination, Clinical Dementia Rating and an EEG analysis of absolute and relative band amplitude at rest. Four groups were compared: three with PD (7 patients with dementia, 10 with mild cognitive impairment and 15 with no cognitive disturbances) and the control group. The qEEG showed no significant differences between the control group and PD patients without cognitive disturbance. Abnormalities on the qEEG were essentially associated with the occurrence of mild cognitive impairment or dementia in patients with PD. There was an increase in the absolute and relative posterior theta amplitude in the groups with mild cognitive impairment or dementia and of the posterior absolute and relative delta amplitude in the group with dementia This study suggested qEEG as a possible physiological tool in the assessment of cognitive aspects in PD.

Desempenho escolar em crianças com epilepsia benigna da infância com pontas centrotemporais

RESUMO - Aspectos psicossociais em criancas com epilepsia benigna da infância com pontas centrotemporais (EBICT) sao objetode controversias. O objetivo desta pesquisa foi estudar o desempenho escolar em criancas com EBICT. Vinte criancas foramsubmetidas ao Teste de Desempenho Escolar (TDE) e comparadas a criancas sadias pareadas por idade e escolaridade.Foram estudada sas relacoes entre o TDE e a lateralidade do foco e o numero de descargas ao eletrencefalograma.As criancas com EBICT tiveram,de modo significativo, mais frequentemente do que as sadias, desempenho inferior no subteste de leitura e no escore total. Ascriancas com desempenho inferior em leitura apresentaram maior numero de descargas do que aquelas com desempenho medioe superior.Nao houve diferencas no TDE segundo a lateralidade do foco.O numero de descargas,ao interferir com a funcao cerebral ,pode ser um fator a explicar o desempenho mais baixo na leitura.PALAVRAS-CHAVE: epilepsia idiopatica, eletrencefalograma, atividade epileptiforme, leitura.School performance in children with benign childhood epilepsy with centrotemporal spikesABSTRACT - Neuropsychological implications of benign childhood epilepsy with centrotemporal spikes-rolandic spikes (BECTS) have not been adequately investigated.The aim of this study was to compare the results in a school perf ormancetest of patients with BECTS and normal age-matched controls.A total of 20 children with BECTS and 20 normal controls were submi ttedto anamnesis, clinical evaluation, Raven test, school performance test (SPT), digital electroencephalogram and quantitativeelectroencephalogram analysis. Comparing with normal controls, children with BECTS showed significantly lower SPT results,especially in reading test.There was an association between the higher number of rolandic spikes and inferior performance in SP Treading test.These findings suggest that discharges may be a factor in the genesis of lower performance in reading test in chil drenwith BECTS.KEY WORDS: rolandic epilepsy, electroencephalogram, epileptiform activity, reading, cognition.

Comparison of quantitative EEG between patients with Alzheimer’s disease and those with Parkinson’s disease dementia

OBJECTIVE Dementia frequently occurs in Parkinsons disease (PD) but its pathophysiological basis is little known. Comparative EEG studies of Alzheimers disease (AD) and Parkinsons disease dementia (PDD) are still rare, but could provide knowledge on the different pathophysiological mechanisms involved. The objective of the present study was to comparatively evaluate the absolute power and coherence on the EEG for patients with AD and PDD. METHODS This study assessed 38 adults with AD, 12 with PDD, 31 with Parkinsons disease without dementia, and 37 controls (CG) by a neurological evaluation, CERAD neuropsychological battery, executive functions tests and qEEG, calculating global absolute powers for the delta, theta, alpha and beta bands and inter- and intra-hemispheric coherences. RESULTS The delta and theta powers were highest in PDD and lowest in CG (p<0.05). The beta frontal-occipital inter-hemispheric coherence was highest in PDD (p<0.05). Whereas, alpha and beta frontal inter-hemispheric coherence was highest in PDD and lowest in AD (p<0.05). CONCLUSION These results suggest that qEEG power and coherence measures are different in AD and PDD. SIGNIFICANCE These qEEG differences must be related to the distinct mechanisms of cortical neural connections in AD and PDD.

Epileptiform abnormalities and quantitative EEG in children with attention-deficit/hyperactivity disorder.

There is much controversy about the importance of the electroencephalogram (EEG) in assessing the attention-deficit/hyperactivity disorder (ADHD). The objective of this study was to assess the use of EEG and quantitative EEG (qEEG) in ADHD children. Thirty ADHD children and 30 sex- and age-matched controls with no neurological or psychiatric problems were studied. The EEG was recorded from 15 electrode sites during an eyes-closed resting condition. Epileptiform activity was assessed, as were the absolute and relative powers in the classical bands after application of the Fast Fourier transform. Epileptiform activity was found in 3 (10%) ADHD children. As compared to the controls, the ADHD group showed significantly greater absolute delta and theta powers in a diffuse way, and also greater absolute beta power and smaller relative alpha 1 and beta powers at some electrodes. A logistic multiple regression model, allowed for 83.3% sensibility and specificity in diagnosing ADHD.

Spiritual/religious coping in patients with epilepsy: relationship with sociodemographic and clinical aspects and quality of life.

One hundred and ten patients with epilepsy with a mean age of 45.9 were assessed by a clinical-neurological evaluation, Quality of Life in Epilepsy Inventory-31 (QOLIE-31), and the Spiritual/Religious Coping (SRCOPE) Scale. The objective of this study was to evaluate if patients with epilepsy used positive and/or negative spiritual/religious coping and the relationships between this type of coping and the sociodemographic and clinical aspects of epilepsy and the QOLIE-31. A greater use of positive coping (3.0±0.7) than negative coping (2.3±0.7) was found. The use of the positive factor was greater in mesial temporal lobe epilepsy (MTLE) than in other types of epilepsy. The ratio of negative/positive coping was associated with lower scores in the QOLIE-31 (-0.222; p=0.036). Patients with epilepsy appear to use spiritual/religious coping, especially those with MTLE, and a predominance of negative coping was associated with a reduced quality of life. Future studies should evaluate interventions considering the knowledge of spiritual/religious strategies by the patients.

Educational problems related to quantitative EEG changes in benign childhood epilepsy with centrotemporal spikes

The relationship between educational problems and clinical/electroencephalographic aspects was assessed in 38 children with benign childhood epilepsy with centrotemporal spikes (BECTS). Children were assessed using the School Performance Test; questionnaires on learning difficulties administered to parents and teachers; the Wechsler Intelligence Scale for Children, Third Edition; and EEGs. Absolute and relative amplitudes in the classic bands (quantitative EEG) and characteristics of epileptiform activity on the EEG were examined. Educational problems were observed in 7 (18.4%) children with BECTS. In this subgroup, relative alpha amplitudes at the central and parietal electrodes were lower as compared with those of the BECTS subgroup with normal educational performance and a control group matched for age, gender, and socioeconomic status. The data indicated a possible relationship between alterations in background brain electrical activity and the tendency toward inferior educational performance in children with BECTS. This study suggested that quantitative EEGs are a possible physiological tool in the assessment of cognitive aspects in children with BECTS.

Quantitative EEG in children with learning disabilities: analysis of band power

In order to better understand the mechanisms of learning disabilities it is important to evaluate the electroencephalogram parameters and their relation to the results of the Wechsler Intelligence Scale. Thirty-six children with complaints of learning disability were studied. Electroencephalograms were carried out while awake and resting, and the values for absolute and relative powers calculated. The results were compared with those of 36 healthy children paired with respect to age, gender and maternal scholastic level. In the group with learning disabilities, the absolute (in the delta, theta and alpha 1 bands) and relative (theta) power values were higher and the relative power alpha 2 value significantly lower at the majority of the electrodes in relation to the control group. There was a high positive correlation in the children with learning disabilities between the relative power alpha 2 and the verbal, performance and total IQ values. These quantitative electroencephalogram findings in children with learning disabilities have a clear relation with psychological measurements and could be due to brain immaturity.

Knowledge and attitudes toward epilepsy amongst students in the health area: intervention aimed at enlightenment

It is known that there is a lack of knowledge about epilepsy amongst the population in general, with consequent prejudice and discrimination towards epileptic patients. Considering the importance of health professionals in the diffusion of knowledge about this neurological condition, the objective of the present study was to evaluate modifications in the knowledge and attitudes of students in the health area with respect to epilepsy, after an intervention including the presentation of specific audio-visual material and a discussion on the basic aspects of epilepsy. Simple self-administered questionnaires were applied to one hundred and sixteen health area students before and after the session of enlightenment. After the session there was significant (p<0.05) improvement in answers to different questions about etiology, epidemiology, education, work, and attitude during the seizure. The results suggest the need to include a routine low complexity educational activity in the curriculum of various courses in the health area.

Calcificação nos núcleos da base na tomografia computadorizada: correlação clínica em 25 pacientes consecutivos

Twenty-five patients presenting basal ganglia calcification were assessed. This finding comprised 0.68% of all skull CT scan carried out during the period. Two patients were neurologically asymptomatic and 23 presented a variety neurological disorders - headache (7 patients), stroke (5 patients), extrapyramidal syndromes (2 patients), tumor (2 patients), epilepsy (1 patient), mental retardation (1 patient), dementia (1 patient), cranial trauma (1 patient), other neurological conditions (3 patients) - or were asymptomatic from the neurological point of view (2 patients). Findings in the CT scan other than the basal ganglia calcification were observed in 15 (60%) patients. There was a clinical-CT scan correlation in these cases but not in those in which the basal ganglia calcification was an isolated finding. This study highlights the fact that basal ganglia calcification is often a nonspecific finding on CT scan and that it may not be possible to establish a clinical-pathological correlation between them.