Abstract :
Neurodevelopmental disability is one of the most common problems of children
referred to Pediatric Neurology Clinics. These children may suffer from speech
delay, intellectual deficiency and behavioral disorder.
Some patients with neurodevelopomental delay, especially those with intellectual
disability and speech problems, have abnormal electroencephalograms, without
clinical seizure. It seems that treating these patients with antiepileptic drugs
normalizes the EEG, thereby preventing the electrical paroxysmal discharges
that could be harmful for the developing brain. Several studies reported the
use of Valproate, Lamotrigine and Corticosteroid in suppression of subclinical
epileptiform discharges and improvement of developmental behavioral
conditions.
In our experiences, oral Na-Valproate was effective in developmental behavioral
condition of children with neurodevelopmental delay and elimination of
subclinical EEG discharges after 18 months of treatment.
Also we used high dose intravenous methyl - prednisolone in a group of
children with neurodevelopmental delay and electrical status epilepticus
during slow - wave sleep without clinical seizure. In these children results of the
appropriate neuro-metabolic tests and magnetic resonance imaging of the brain
revealed no abnormality. Because no underlying etiology could be determined,
isolated non convulsive status epilepticus was established. After treatment no
significant response was observed in these group of children.
In another study we used Lamotrigine in children with neurodevelopmental
delay, abnormal epileptiform discharges but without clinical seizures. Our
results revealed Lamotrigine provides effective control of both subclinical
epileptiform discharges and behavioral disorder, without improvement in their
cognition. Further studies are needed to investigate and confirm the cognitive and
behavioral effects of Lamotrigine in children with psychomotor retardation.
