What did the project achieve?
“Our study has both improved our understanding about the causes of learning disabilities in children with epilepsy, as well as the characteristics of sleep in children with epilepsy and its relationship to seizures,” says Professor Helen Cross of the UCL Great Ormond Street Institute of Child Health.
Epilepsy affects around one in every 200 children and young people under 18 in the UK.1 Around one in five people with epilepsy also has a learning disability and it is thought that for these people, both conditions may be caused by the same underlying problem with their brain.2
“The impact of epilepsy on a child’s learning and development is a major concern for families, yet we know little about how epilepsy leads or contributes to these problems,” says Professor Cross. “But we suspect that sleep disruption is involved.”
Sleep is thought to play a vital role in new experiences being stably committed into our long-term memory, which is an essential part of learning. But this ‘memory consolidation’ process may be impacted in children with epilepsy if their sleep is disrupted – either due to seizures while they are asleep or epileptic brain activity occurring between seizures.
“Our study involved analysing the brainwaves of children with and without a type of epilepsy, while they were awake or sleeping. We also asked them to do a fun memory test as a measure of their ability to consolidate memories,” says Professor Cross.
“Our results show that children with epilepsy gain the same benefits from sleep as other children. They also suggest that a type of sleep known as ‘slow wave’ is particularly important for memory consolidation. So, finding ways to improve this type of sleep through behavioural, drug or physical interventions, might be a way to improve learning outcomes in patients with epilepsy,” she adds.
- Epilepsy society: https://www.epilepsysociety.org.uk/epilepsy-childhood#.WoMqnujFJPY [website accessed 08 March 2018)
- Epilepsy society: https://www.epilepsysociety.org.uk/learning-disabilities#.WqExWejFJPY [website accessed 08 March 2018)
This research was completed on
Around 60,000 children have epilepsy in the UK.1,2 Evidence suggests around one person in every five with epilepsy also has a learning disability.1 Professor Helen Cross, of University College London Institute of Child Health, is investigating whether learning problems in children with epilepsy are linked to disruption of sleep patterns and to epileptic activity within the brain. If they are, better control of children’s epilepsy, particularly during the night, might improve learning.
What is the problem and who does it affect?
“Learning disabilities are common in children with epilepsy,” says Professor Cross. “Children whose epilepsy begins early in life are particularly vulnerable, especially if their seizures cannot be controlled.” Sadly, around 30 per cent of children with epilepsy will continue to have seizures despite trying all available treatments.2
“Children with both epilepsy and learning disabilities can have difficulties at school and with their relationships with their peers,” explains Professor Cross. “The children’s learning level might be much lower than expected for their age.” Children might have general difficulties with reading, writing and maths, for example, or more subtle problems with their concentration and memory.
“Learning disabilities in children with epilepsy are a major concern for parents, but the exact cause of these disabilities remains unclear,” says Professor Cross. “Controversy surrounds how much the underlying cause of a child’s epilepsy, and the seizures themselves, each contribute to learning disabilities.”
“Another factor that has received little attention is disruption of sleep. We know that sleep plays an important role in learning. Evidence suggests it helps memories to be laid down. However, we don’t know how disrupted sleep affects children with epilepsy. This is an important missing link in our knowledge.”
What is the project trying to achieve?
“We aim to boost understanding of why so many children with epilepsy have learning disabilities,” explains Professor Cross. “We are investigating whether poor learning correlates with disruption of normal sleep patterns, and with the abnormal electrical activity that takes place within the brain when children have epilepsy.”
Around 60 children with two different types of epilepsy are taking part in this study, along with 20 healthy children. The researchers are assessing the children’s brain waves over 24 hours – while they are awake and while they are sleeping – using a technique called video EEG telemetry. During this period, they are also assessing the children’s ability to learn and remember new things using fun, memory tests.
“It’s possible that more effective treatment of sleep disruption, and epileptic activity within the brain, might benefit children by improving learning,” explains Professor Cross. “Further studies in this area are planned.”
What are the researchers’ credentials?
Professor Cross is a world expert in childhood epilepsy, with a long and successful track record in studying learning disabilities in children with epilepsy and the role of early treatment in improving children’s lives. The research is taking place in two centres with state-of-the-art facilities: London’s Great Ormond Street Hospital for Children and Young Epilepsy, Lingfield.
- Epilepsy Society. About epilepsy. Children. Epilepsy in childhood. http://www.epilepsysociety.org.uk/AboutEpilepsy/Epilepsyandyou/Childrena... Website accessed 20 February 2013.
- Joint Epilepsy Council of the UK and Ireland. Epilepsy prevalence, incidence and other statistics. December 2011. http://www.jointepilepsycouncil.org.uk/ Website accessed 8 February 2013.
|Project Leader||Professor J Helen Cross MB ChB PhD FRCP FRCPCH|
|Project Team||Dr Samantha Chan MBChB BSc MRCPCHDr Torsten Baldeweg MDDr Ronit Pressler PhD MD MRCPCHProfessor Rod Scott MBChB MRCPCH PhDDr Krishna Das MBBS DCH MD DM FRCPCHDr Stewart Boyd MB ChB MD|
|Project Location||University College London, Institute of Child Health|
|Project Location Other||Great Ormond Street Hospital for Children NHS TrustYoung Epilepsy, Lingfield, Surrey|
|Project duration||2 years|
|Date awarded||15 November 2012|
|Project start date||1 June 2013|
|Project end date||26 August 2016|
|Acknowledgements||This project is funded by a generous donation from The Henry Smith Charity|