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The effectiveness of valproic acid (V.P.A.) in the symptomatic treatment of child's seizures is well established. Its lack of side-effects detrimental to the child's development and, on the contrary, its often positive action on awareness and attention should lead to choose V.P.A. as the first and main therapy. All night sleep recordings have been largely used to study the consequences of drug intake and drug withdrawal. It seemed interesting a) to control the effects of V.P.A. on sleep parameters when it was given as first treatment and b) to compare its effects to those of barbiturates when it was given in substitution. The study of sleep parameters seems to evidence that the often obtained clinical efficiency of V.P.A. parallels the restoration of a physiological functioning of the central nervous system normal or closer to normal.

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An automatic analysis of the topographical distribution of slow sleep rhythms was performed and 53 night sleep recordings obtained from 10 children chronically treated by barbiturates; a barbiturate withdrawal was undertaken in these children to eliminate the side effects of the drug likely to impair their development or their behaviour. Compared to the data obtained in a control group, marked differences were observed in this population, bearing on the magnitude, the topographical distribution and the interhemispheric symmetry of the delta power curves. During and after withdrawal, changes could occur in these curves; as a whole, the organization of the curves was closer to those of controls when the withdrawal was completed for at least 2 months but their magnitudes remained either higher or lower than control values. No relationship could be established between the curve parameters and the dosage of the drug. The observed changes between successive records are interpreted in relation to the concept of cerebral plasticity.

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The present paper deals with a transitory axial EMG phenomenon during sleep: muscular contractions visible not only on the EMG channel but on the EEG channels as well. Only those contractions which did not lead to behavioural or electrical awakening were considered here. Records were kept on their number, duration, time of occurrence during the night as well as the sleep stage and the level of the background tonic EMG activity during the 2 minutes preceding and succeeding the contraction. The function of these contractions in the regulation of sleep was discussed: the need for tonic reafferentation or counteraction of prolonged axial hypotony which may bring about discomfort; the maintenance of sleep throughout this periodic reafferentation.

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This study concerns the evolution of slow EEG activities (delta rhythms) and their topographical distribution during 31 night sleep records of 27 control subjects whose ages ranged from 1 month to 27 years. A system of data processing allows the representation of continuous changes in 8 derivations of the power of 0.5--4.5 c/sec waves. The obtained curves, whose respective magnitudes depend on the chosen montage, parallel the sleep cycles of the classical hypnogram. They do not clearly differentiate NREM sleep stages, but show a progressive increase of delta rhythm power with the deepening of NREM sleep. Moreover, measurement of the magnitude to these curves allows comparisons between the different channels in a given record and between different recordings. With the referential setting used in this study the topographical organization of the occipital, parietal and central curves proved occipital, parietal and central curves proved remarkably consistent in all subjects. The general magnitude of these curves decreased with age while that of frontal curves slightly increased. The right parietal curves were of greater magnitude than the left in every record obtained from children aged 2--5 years. The changes with age, and the intra- and interindividual differences are discussed. The data suggest hypotheses about the importance of NREM sleep in developmental processes.

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A study of phasic suppressions of tonus in 172 sleep recordings of healthy subjects aged from 3 days to 25 years demonstrated that phasic suppressions of tonus may occur from 3 days of age, and that the time when they appear to related neither to the presence of E.E.G. transients nor to the imminence of the onset of paradoxical sleep. the number of sleep recordings showing phasic suppression is very low in youngest infants and increases after the 6th month. The number of phasic suppressions per 100 min. of slow sleep with tonus is fairly stable after 6 years of age, whereas there is an extreme inter-individual variability between 2 and 6 years. These data are interpreted in relation to maturation and development.

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The case of a child under continuous anticonvulsant medication, especially barbiturate, since the age of 8 months for atypical seizures is reported. Medication was withdrawn when the child was 7.7 years old. The child was then under care in a Day Hospital with an autistic-like syndrome associated with important disturbances of sleep-waking regulation, complete learning incapability and major EEG abnormalities. The EEG paroxysmal discharges observed in the waking and all-night sleep records gradually decreased and then disappeared as the withdrawal was pursued over a period of several months. During the same period, the child's behaviour markedly improved and his sleep disturbances disappeared. The possibility of iatrogenic effects of early and continuous anti-convulsant therapies is discussed, even though the drug plasma levels remain within ranges generally considered as non-toxic.

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From four cases studied both clinically and with the help of repeated and prolonged electroencephalograms, the problems raised by the association psychosis-epilepsy in children are reconsidered. The difficulties in evaluating: the actual weight of the "epilepsy" component; the role of the epileptic discharge for the subject's psychic economy; the role of drug therapies, are particularly underlined.

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In visually defective children occipital spikes were analysed in periods with and without eye movements during paradoxical sleep. A decrease was shown in correspondence with eye movements, mainly when the spike rate was low.

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Asymmetrical electrical activity was noted during sleep in normal children both during "mixed patterns" of sleep and during paradoxical sleep. This phenomenon is particularly striking between the ages of 3 and 5 years.

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