Cognitive and other neuropsychological profiles in children with newly diagnosed benign rolandic epilepsy

Abstract

PurposeAlthough benign rolandic epilepsy (BRE) is a benign condition, it may be associated with a spectrum of behavioral, psychiatric, and cognitive disorders. This study aimed to assess the cognitive and other neuropsychological profiles of children with BRE.MethodsIn total, 23 children with BRE were consecutively recruited. All children underwent sleep electroencephalography (EEG) and were assessed on a battery of comprehensive neuropsychological tests including the Korean versions of the Wechsler intelligence scale for children III, frontal executive neuropsychological test, rey complex figure test, Wisconsin card sorting test, attention deficit diagnostic scale, and child behavior checklist scale.ResultsThe study subjects included 13 boys and 10 girls aged 9.0±1.6 years. Our subjects showed an average monthly seizure frequency of 0.9±0.7, and a majority of them had focal seizures (70%). The spike index (frequency/min) was 4.1±5.3 (right) and 13.1±15.9 (left). Of the 23 subjects, 9 showed frequent spikes (>10/min) on the EEG. The subjects had normal cognitive and frontal executive functions, memory, and other neuropsychological sub-domain scores, even though 8 children (35%) showed some evidence of learning difficulties, attention deficits, and aggressive behavior.ConclusionOur data have limited predictive value; however, these data demonstrate that although BRE appears to be benign at the onset, children with BRE might develop cognitive, behavioral, and other psychiatric disorders during the active phase of epilepsy, and these problems may even outlast the BRE. Therefore, we recommend scrupulous follow-up for children with BRE.

Generalized epilepsy and febrile seizures plus (GEFS+) in a series of 22 patients

“…This proportion is a bit lower than percentages found in epilepsy, which may reach one fourth to one third of patients with an associated SLI diagnosis [27,28]. This difference may also be explained by the absence of rolandic epilepsy patients in our series (SLI, just like SLD, is more frequent in this epilepsy group) [28,29]. Two of the patients previously diagnosed with SLI were subsequently diagnosed to have SLD.…”

Memory in children with epilepsy: A systematic review

“…Table 2 illustrates the scores of children with epilepsy on standardised assessment instruments in comparison to normative scores on these instruments. With the exception of seven (21%) studies, 53,56,64,[76][77][78][79] children with epilepsy scored below normative scores on measures of memory. With the exception of Kernan et al, 26 comparison of children with epilepsy versus controls or normative controls have not controlled for IQ, making it difficult to ascertain whether memory difficulties are over and above global cognitive impairments.…”

The Clinical Spectrum of Benign Epilepsy with Centro-Temporal Spikes: a Challenge in Categorization and Predictability

“… 8 Various neuropsychological deficits seem to be very dependent on the sleep-wake cycle and spike index, as well as the predominant localization of epileptiform discharges. 9 – 15 Furthermore, the frequency of epileptiform discharges is closely related not only to the degree of neuropsychological deficits, but also to an atypical evolution of BECTS. The atypical evolution of BECTS can result in atypical benign childhood focal epilepsy (ABCFE), status epilepticus of BECTS (SEBECTS), Landau-Kleffner syndrome (LKS), and epileptic encephalopathy with continuous spike-and-wave during sleep (CSWS), which are considered as different entities, but are part of a single spectrum of disorders.…”

“… 22 – 25 In addition, previous studies have shown that many children with atypical features are likely to have linguistic, learning, or behavioral difficulties. 15 – 17 , 20 , 25 – 28 The common comorbidities are listed in Table 1 .…”