Rolandic spikes in children with PVL and epilepsy
Research type
Research Study
Full title
Rolandic spikes and sleep activated interictal discharges in children with periventricular leucomalacia and epilepsy
IRAS ID
233674
Contact name
Judith Kalser
Contact email
Sponsor organisation
Great Ormond Street Hospital for Children NHS Foundation Trust
Clinicaltrials.gov Identifier
2162, Audit Department GOSH/ICH
Duration of Study in the UK
0 years, 9 months, 1 days
Research summary
Periventricular leucomalacia (PVL) is a leading cause of cerebral palsy (CP). Cognitive impairment, behavioural problems and epilepsy are frequent in this population. The incidence of epilepsy in patients with PVL is reported ranging from 7% to 47%. Its underlying pathophysiology, when no visible cortical damage is associated, is still unclear. In the literature epilepsy in patients with CP is describe as heterogeneous regarding age of onset, type of seizure, response to treatment and electroencephalographic pattern. However, only a few studies address specifically PVL patients as a subgroup of CP patients. \nIn our clinical experience, some of the patients with PVL show electroencephalographic (EEG) features of idiopathic focal epilepsy of childhood (IFE), especially of rolandic epilepsy (RE, or childhood epilepsy with centro-temporal spikes). The significance of these EEG features from a clinical and physiopathological prospective is still unclear. In Furthermore, CSWS continuous spike and wave during slow-wave sleep which is thought to be at the severe end of the IFE-spectrum, has been described in 6% of patients with PVL thus in almost 1/5 (19%) of the group of children with PVL and epilepsy. Children may experience cognitive and behavioural regression due to the electrical status epilepticus during sleep. \nWe now wish to review our data of children with epilepsy and PVL due to prematurity includes clinical history (motor and cognitive development, epilepsy, personal medical and family history), brain MRI scans and EEG exams. Our objective is to determine the relevance of rolandic spikes (mimics of idiopathic focal epilepsy) to prognosis and response to treatment in these patients, but also to better understand the underlying physiopathological mechanisms. With these results we aim to improve clinical management (treatment and monitoring with EEGs) of these patients.
REC name
London - Camden & Kings Cross Research Ethics Committee
REC reference
18/LO/0884
Date of REC Opinion
11 Jun 2018
REC opinion
Favourable Opinion