Bildgebung bei epileptischen Enzephalopathien

Epileptic encephalopathies (EE) belong to the group of epilepsies which are associated with expressed cognitive and behavioral disturbances subsequent to epileptic activity. Despite the great importance of EE in the development and psychosocial adaptation of affected children, the mechanisms of cognitive deficits in EE have so far been insufficiently investigated. This review article summarizes the various neuroimaging studies which have tried to describe specific neuronal networks in EE. The results show that although epileptic activity in EE can be generated in different brain regions, specific propagation pathways and networks exist which are very characteristic for each different form of encephalopathy. In some forms of EE the epileptic activity seems to impair the integrity of the default mode network and possibly to interfere with cognitive function through this mechanism. Furthermore, there are further mechanisms underlying EE, e.g. abnormal connectivity patterns between brain regions which participate in the control of cognitive functions and impairment of the connections and activities in the thalamocortical network.