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AIM Epilepsy is associated with difficulties in cognition and behavior in children. These problems have been attributed to genetics, ongoing seizures, psychosocial issues, underlying abnormality of the brain, and ⁄ or antiepileptic drugs. In a previous study, we found baseline cognitive differences between children with partial versus generalized and convulsive versus non-convulsive seizures. Measures in that study focused primarily on IQ scores. In the present study, we assessed baseline function with respect to new learning, attention, and memory, thus providing a more comprehensive profile than our previous study. METHODWe examined 57 children (42 females, 15 males), aged 6 to 17 years (mean 10y 1mo, SD 2y 9mo), with new-onset, idiopathic epilepsy, using tests of cognitive function reflective of new learning, memory, and attention. Seizures were classified as generalized convulsive (n=5), generalized non-convulsive (n=18), or focal (n=34). Focal seizures were divided into unilateral versus bilateral independent foci, and presence versus absence of secondary generalization.RESULTS Attention was a particular area of weakness across all groups. The Vocabulary score of an intelligence screen was higher for the focal seizure groups (p=0.012), primarily because of a difference between the unilateral focal and the primary generalized groups (p<0.047). Children with generalized, non-convulsive seizures performed significantly worse than the focal group on a measure of short-term auditory memory (p=0.019). All groups performed poorly on a test of visualmotor speed.INTERPRETATION These findings suggest intrinsic abnormalities in children with new-onset, idiopathic epilepsy at baseline.Epilepsy has been associated with difficulties in cognitive and behavioral performance in children. These problems have been attributed to an interplay of genetics, ongoing seizures, subclinical epileptiform discharges, postictal states, psychosocial issues, underlying abnormality of the brain, and the use of antiepileptic drugs. 1-9Studies attempting to identify the cause of impairment of learning and behavioral function in children with epilepsy are limited by methodological shortcomings, including variability of seizure type and etiology, absence of baseline data, polypharmacy, and attributing disturbances to antiepileptic drugs by default.10,11 Overall, there have been few prospective studies that have investigated baseline performance in children to characterize better the problems intrinsic to the epileptic condition.A study by Seidenberg et al. 12 pointed to impaired academic performance in children with epilepsy, with correlations to the number of lifetime seizure episodes, earlier onset of seizures, and multiple types of seizure. Increased rates of psychiatric problems, such as psychosis and depression, and diminished quality of life have been observed in children with epilepsy compared with typically developing children.13,14 Inattention, poor concentration, hyperactivity, and anxiety are also seen with increased frequency.15 ...

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Coronavirus SARS-CoV2 has emerged as one of the greatest infectious disease health challenges in a century. Patients with multiple sclerosis (MS) have a particular vulnerability to infections through their use of immunosuppressive disease-modifying therapies (DMTs). Specific DMTs pose particular risk based on their mechanisms of action (MOA). As a result, patients require individualized approaches to starting new treatments and continuation of therapy. Additionally, vaccinations must be considered carefully, and individuals on long-term B cell–depleting therapies may have diminished immune responses to vaccination, based on preserved T cells and diminished but present antibody titers to influenza vaccines. We review the immunology behind these treatments and their impact on COVID-19, as well as the current recommendations for best practices for use of DMTs in patients with MS. Supplementary Information The online version contains supplementary material available at 10.1007/s13311-021-01008-7.