Hideaki Kanemura and Masao Aihara
The degree of behavioral problems associated with epilepsy in children is greater than would be expected on the basis of the existence of a chronic illness alone. Involvement of the frontal lobe such as atypical evolution of benign childhood epilepsy with centrotemporal spikes (BCECTS), epilepsy with continuous spike-waves during slow sleep (CSWS), and frontal lobe epilepsy (FLE) are characterized by impairment of neuropsychological abilities, and are frequently associated with behavioral disorders. In volumetric studies using three-dimensional (3D) magnetic resonance imaging (MRI), frontal and prefrontal lobe volumes revealed growth disturbance in patients with atypical evolution of BCECTS, CSWS, and FLE compared with those of normal subjects. These studies also revealed that in patients with shorter seizure durations and abnormal EEG periods, developmental abnormalities of the frontal
lobe were soon restored to a more normal growth ratio. Conversely, growth disturbances of the prefrontal lobes were persistent in the patients with longer seizure durations and abnormal EEG periods. These findings suggest that seizure and the duration of paroxysmal anomalies may be associated with prefrontal lobe growth abnormalities, which are associated with neuropsychological problems. The urgent suppression of these seizure and EEG abnormalities may be necessary to prevent the progression of neuropsychological impairments.