Pediatrics & Therapeutics
Open Access

Abstract

Passive Testing of Cognitive Function in Epileptic Children Unwilling or Unable to Cooperate: Comprehensive Summary of Non-Invasive Neurophysiological Approaches

Milena Korostenskaja, Ki H Lee, James Baumgartner and Eduardo M Castillo

Epilepsy surgery is a potentially curative option for children with intractable epilepsy. In order to avoid postsurgical deficits in language and cognitive functioning, the mapping of these brain functions must be performed. Neurophysiological techniques, such as Electroencephalography (EEG) and Magnetoencephalography (MEG) are non-invasive procedures that can be used to attain this goal. However, they often fail when used to perform functional mapping in uncooperative patients who are unwilling, or unable to communicate or follow the commands. Therefore, there is a need for cognitive function mapping procedures that can be performed without active patient’s participation. The aim of this paper is to integrate and organize currently existing body of knowledge regarding passive testing of information processing and cognitive functioning in pediatric epilepsy patients. It is the first attempt to present a cohesive summary of literature regarding this topic. We will summarize results from currently available passive paradigms for neurophysiological assessment. There are a number of paradigms that could be used for passive evaluation of cognitive function in children with epilepsy. Examples include odd-ball paradigms eliciting Mismatch Negativity (MMN) and P3a responses, continuous word recognition paradigm, and story listening paradigms. In addition, resting state connectivity analysis with correlation to the cognitive testing/behavioral data can be used. Importantly, the majority of these paradigms can be performed during sedation.