Developmental and epileptic encephalopathy with spike–wave activation in sleep: From the ‘functional ablation’ model to a neurodevelopmental network perspective

Abstract

The interplay between epilepsy and cognition is intricate and multifaceted, particularly in the context of childhood-onset epileptic disorders where epileptic activity can significantly interfere with and disrupt the delicate, highly plastic, and environment-related trajectories of neurodevelopment. Developmental and epileptic encephalopathy with spike–wave activation during slow sleep (D/EE-SWAS), a spectrum of conditions including Landau-Kleffner syndrome, could serve as a valuable model to explore these complexities. Research to date has primarily examined its distinctive features, including genetic and structural etiological factors, electroencephalographic patterns, and cognitive phenotypes, often interpreted through simplified cause–effect paradigms. The adoption of a network perspective that aligns with neurodevelopmental trajectories is essential to grasp the full complexity of this evolving condition. Advancing research requires the integration of multimodal data, while leveraging tools such as artificial intelligence to develop sophisticated models in order to achieve a holistic understanding of D/EE-SWAS.