In epilepsy syndromes of childhood with sleep activation, defined as the spectrum of epileptic conditions going from classical benign childhood epilepsy with centrotemporal spikes (BECTS) to epileptic encephalopathy (EE) with continuous spike and waves during slow-wave sleep (CSWS) including Landau-Kleffner syndrome (LKS), a lot of functional imaging studies have been performed so far, leading to results that are not always consistent, related to the technique of neuroimaging performed and to the variability of the clinical phenotype. Most consistent findings are, depending of the method used, activations or increased regional glucose metabolism in the epileptogenic regions, and deactivations, hypometabolism or decreased functional connectivity in cortical regions that belong to the default mode network. Functional changes are either transitory, temporally related to the occurrence of interictal epileptiform discharges (IED), or permanent, persisting across IED-free periods. Some studies have shown that the more severe phenotype, i.e. EE with CSWS, displays the more profound functional disturbances. Taken together, functional imaging studies support the concept that IED impact cognition in epilepsy syndromes of childhood with sleep activation. However, the precise chronology between the occurrence of IED and the functional disturbances, the neuropsychological correlates of the functional disturbances, and the effects of the anti-epileptic treatments on IED, functional disturbances and cognition need to be further studied.

中文翻译：

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伴有睡眠激活的儿童癫痫综合征：来自功能成像的见解

在伴有睡眠激活的儿童期癫痫综合征中，定义为从经典良性儿童癫痫伴中央颞区棘波 (BECTS) 到在慢波睡眠 (CSWS) 期间伴有连续棘波和波的癫痫性脑病 (EE) 的癫痫病谱，包括 Landau- Kleffner 综合征 (LKS)，迄今为止已进行了大量功能成像研究，导致结果并不总是一致，这与所执行的神经成像技术和临床表型的可变性有关。最一致的发现是，取决于所使用的方法，致癫痫区域的激活或区域葡萄糖代谢增加，以及属于默认模式网络的皮层区域的失活、代谢减退或功能连通性降低。功能变化要么是暂时的，时间上与发作间期癫痫样放电 (IED) 的发生有关，或在无 IED 期间持续存在。一些研究表明，更严重的表型，即具有 CSWS 的 EE，显示出更严重的功能障碍。总之，功能成像研究支持 IED 影响睡眠激活儿童癫痫综合征认知的概念。然而，需要进一步研究 IED 发生与功能障碍之间的确切时间顺序、功能障碍的神经心理学相关性以及抗癫痫治疗对 IED、功能障碍和认知的影响。一些研究表明，更严重的表型，即具有 CSWS 的 EE，显示出更严重的功能障碍。总之，功能成像研究支持 IED 影响睡眠激活儿童癫痫综合征认知的概念。然而，需要进一步研究 IED 发生与功能障碍之间的确切时间顺序、功能障碍的神经心理学相关性以及抗癫痫治疗对 IED、功能障碍和认知的影响。一些研究表明，更严重的表型，即具有 CSWS 的 EE，显示出更严重的功能障碍。总之，功能成像研究支持 IED 影响睡眠激活儿童癫痫综合征认知的概念。然而，需要进一步研究 IED 发生与功能障碍之间的确切时间顺序、功能障碍的神经心理学相关性以及抗癫痫治疗对 IED、功能障碍和认知的影响。