Self-limited childhood epilepsies are disorders of the perisylvian communication system,
carrying the risk of progress to epileptic encephalopathies-Critical review.
"Sleep plasticity is a double-edged sword: a powerful machinery of neural build-up,
with a risk to epileptic derailment." We aimed to review the types of self-limited
focal epilepsies..."i.e. keep as two separate paragraphs" We aimed to review the types
of self-limited focal epilepsies: (1) self-limited focal childhood epilepsy with centrotemporal
spikes, (2) atypical Rolandic epilepsy, and (3) electrical status epilepticus in sleep
with mental consequences, including Landau-Kleffner-type acquired aphasia, showing
their spectral relationship and discussing the debated topics. Our endeavor is to
support the system epilepsy concept in this group of epilepsies, using them as models
for epileptogenesis in general. The spectral continuity of the involved conditions
is evidenced by several features: language impairment, the overarching presence of
centrotemporal spikes and ripples (with changing electromorphology across the spectrum),
the essential timely and spatial independence of interictal epileptic discharges from
seizures, NREM sleep relatedness, and the existence of the intermediate-severity "atypical"
forms. These epilepsies might be the consequences of a genetically determined transitory
developmental failure, reflected by widespread neuropsychological symptoms originating
from the perisylvian network that have distinct time and space relations from secondary
epilepsy itself. The involved epilepsies carry the risk of progression to severe,
potentially irreversible encephalopathic forms.