[Cognitive and behavioral consequences of epilepsy during the course of brain development].

Abstract

The notion that cognitive and behavioural dysfunctions of epileptic origin can be prolonged and with an insidious onset, has meant a radical conceptual change about epilepsy considered so far uniquely as a paroxysmal disorder. Also, these dysfunctions can be the only observable manifestations of the disorder. It is particularly true in some epileptic syndromes with onset in childhood. Epileptic dysfunctions are characterized by a discontinuity in time (intermittent, recurrent), in space (cerebral localization of the dysfunction and its spread). They often have a significant relationship with sleep. These features, with sometimes the existential dimension of some symptoms (intermittent loss of the flux of consciousness, intermittent perceptual distortions or cognitive-emotional dysfunction) are not seen in any other congenital or acquired disorders of the human brain. Longitudinal clinical studies in which the epileptic variable can be directly correlated with the precise study of the cognitive dysfunction (also with increasingly complex methods of brain imaging) are a difficult, relatively new multidisciplinary task, especially in the very young child. Case examples of children followed from early childhood to adulthood will illustrate the diversity of observed cognitive and behavioural abnormalities directly caused by the epileptic activity which can be massive or very discrete. One is only beginning to document precisely the late consequences (or absence of) of some early childhood epilepsies that had a direct impact on developing brain function at some point.