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Neuropsychological and behavioral status were examined in 57 children aged 7 to 16 years with complex partial seizures (CPS) and compared with 27 sibling control children of the same age. Epilepsy had a significant effect on both cognitive and behavioral adjustment measures. Children with CPS had significant impairment across all seven cognitive domains assessed, reflective of a profile of relatively diffuse and generalized cognitive dysfunction. Age at onset of recurrent seizures was the strongest and most consistent predictor of adequacy of cognitive functioning; earlier age at onset was associated with poorer cognitive status. Children with CPS also had more problems compared with sibling control children on measures of social and school competence and internalizing behavior problems, but not externalizing behaviors. Further, frequency of seizure activity in the past year, rather than age at seizure onset, emerged as the strongest predictor of these behavioral difficulties. These findings are discussed in the context of understanding the impact of CPS on cognition and behavioral adjustment, and identifying the contribution of various aspects of the neurodevelopmental course of CPS to these issues.

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Premature infants treated with inhaled nitric oxide have improved neurodevelopmental outcomes at two years of age.

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A series of experiments investigated the effects of continuous broadband noise (ipsilateral) on wave V of the click-evoked brainstem auditory evoked response (BAER). In general, a broadband noise masker increases the latency and decreases the amplitude of wave V. Varying both click and noise intensity, it was found that noise levels above about 40 dB SPL increase the latency and decrease the amplitude of wave V, regardless of click intensity. The effects of noise on wave V amplitude appear constant across click intensity, whereas the effects of a constant noise level on wave V latency decrease at higher click intensities. Both masking and adaptation increase wave V latency, but their combined effects are occlusive: rate-induced wave V latency shift decreases in the presence of continuous broadband noise. The clinical and theoretical implications of these findings are discussed.

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Brainstem auditory evoked responses (BAERs) were measured in pediatric patients with neurologic diseases. Abnormalities of interwave intervals, amplitude ratios, and response to changing rate of stimulation were found in patients with tumors, myelin disorders, anoxic-ischemic encephalopathy, trauma, and neurodegenerative disorders. Reversibility of brainstem abnormalities (excluding multiple sclerosis) and sensitivity to toxic-metabolic disorders are features of the response not previously described in adults with neurologic disorders. The BAER is a promising new tool for the investigation of pediatric neurologic disease.