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Aim: To investigate the link between sleep disruption and cognitive impairment in childhood epilepsy by studying the effect of epilepsy on sleep homeostasis, as reflected in slow‐wave activity (SWA). Method: We examined SWA from overnight EEG‐polysomnography in 19 children with focal epilepsy (mean [SD] age 11 years 6 months [3 years], range 6 years 6 months–15 years 6 months; 6 females, 13 males) and 18 age‐ and sex‐matched typically developing controls, correlating this with contemporaneous memory consolidation task scores, full‐scale IQ, seizures, and focal interictal discharges. Results: Children with epilepsy did not differ significantly from controls in overnight SWA decline (p = 0.12) or gain in memory performance with sleep (p = 0.27). SWA was lower in patients compared to controls in the first hour of non‐rapid eye movement sleep (p = 0.021), although not in those who remained seizure‐free (p = 0.26). Full‐scale IQ did not correlate with measures of SWA in patients or controls. There was no significant difference in SWA measures between focal and non‐focal electrodes. Interpretation: Overnight SWA decline is conserved in children with focal epilepsy and may underpin the preservation of sleep‐related memory consolidation in this patient group. Reduced early‐night SWA may reflect impaired or immature sleep homeostasis in those with a higher seizure burden. What this paper adds: The decline in slow‐wave activity (SWA) across the night, reflecting global synaptic downscaling, was preserved in children with focal lesional epilepsies.Sleep benefited memory consolidation in this group of patients, as in typically developing children.Reduced early‐night SWA was associated with increased likelihood of a subsequent seizure. [ABSTRACT FROM AUTHOR]

Aim Method Results Interpretation To evaluate a group of children with epilepsy and motor speech regression, with the aim of characterizing their speech disorders, electrographic features, and outcomes.Children referred to a tertiary developmental epilepsy clinic with epilepsy and motor speech regression were identified retrospectively. A clinical history was taken, and longitudinal speech and cognitive data were recorded. Speech samples were scored for severity and speech features. Seizure frequency and epileptiform discharges in the interictal electroencephalogram were analysed.Eighteen children (10 female) were evaluated, including seven with Landau–Kleffner syndrome and six with Rasmussen syndrome. Speech regression occurred at a mean age of 5 years (SD = 2 years 6 months), which was concurrent with seizure onset or peak seizure burden in eight children. Speech features included dysarthria (n = 13), phonological errors (n = 7), and dyspraxia (n = 6). Electrographic abnormalities occurred most frequently in the left centrotemporal and right frontal regions. Among children who were followed up, intelligibility of speech was affected in 13 at baseline and seven at follow‐up (p = 0.03). Expressive language standardized scores increased from a mean (SD) of 50.0 (11.3) to 91.4 (27.8) in children with Landau–Kleffner syndrome (mean change = 41.4, 95% confidence interval [CI] 0.04–82.8, p = 0.0498) and decreased from 75.2 (15.3) to 59.0 (9.8) in children with Rasmussen syndrome (mean change −16.2, 95% CI −9.0 to −23.4, p = 0.002) over the follow‐up.Motor speech disorders in epilepsy were severe, multifarious, and often fluctuated with seizure burden. Symptoms typically improved, especially in children with Landau–Kleffner syndrome, but rarely fully resolved. [ABSTRACT FROM AUTHOR]