Formal Thought Disorder in Pediatric Complex Partial Seizure Disorder

Abstract

We compared the formal thought disorder ratings of 27 children with complex partial seizure disorder, 31 schizophrenic children and 58 normal children. The epileptic children with fullscale IQ scores below 100 had significantly more formal thought disorder than normal children with a similar IQ. The severity of their formal thought disorder was related to the age of seizure onset, seizure control and a diagnosis of schizophrenia spectrum disorder. The schizophrenic children had thought disorder irrespective of IQ scores. The cognitive correlates of their formal thought disorder scores differed from those of the epileptic children. Possible anatomical substrates of thought disorder in childhood complex partial seizure disorder and schizophrenia are discussed.

Social communication in children with epilepsy

“…When we studied smaller samples of CPS and PGE subjects (Caplan et al., 1992a, 1994, 1997), we found that poor seizure control, EEG evidence for focal activity in the temporal and frontal lobe, and age of onset were related to the severity of impaired social communication in the CPS, whereas chronological age and age of onset were associated with the severity of social communication deficits in the PGE group. By using a large representative sample of patients in the current study, we were better able to examine the confounding effects of seizure control, number of AEDs, age of onset, and IQ scores on the severity of social communication deficits.…”

“…Studies in adults (Csernansky, Leiderman, Mandbach, & Moses, 1990; Slater & Beard, 1963) and children (Caplan, Guthrie, Shields, & Mori, 1992a; Caplan et al., 1997) have demonstrated that formal thought disorder is found in patients with complex partial seizure disorder (CPS). Evidence for a schizophrenia‐like psychosis in temporal lobe epilepsy (Caplan, Shields, Mori, & Yodoven, 1991; Lindsay, Ounsted, & Richards, 1979; Mellers, Toone, & Lishman, 2000; Schmitz, Robertson, & Trimble, 1999) and involvement of the temporal lobe in the thought disorder of schizophrenic adults (Holinger et al., 1999; Shenton et al., 1992) led us to investigate if these social communication deficits occur specifically in children with CPS and focal temporal involvement compared to children with primary generalized epilepsy with absences (i.e., petit mal) (PGE).…”

Research Update: Childhood‐onset Schizophrenia: Implications of Clinical and Neurobiological Research

“…onset between 5 and 12) psychosis also had temporal lobe epilepsy, a substantially greater rate than that reported for patients with adult schizophrenia (Stevens, 1991). Interestingly, Caplan and colleagues (Caplan, Guthrie, Shields, & Mori, 1992 ;Caplan et al, 1993) have found that children with complex partial seizure disorders have significantly more illogical thinking and use significantly fewer linguistic cohesive devices. One long-term follow-up study found that of 100 children with temporal lobe epilepsy, 10 % developed schizophrenia in adulthood (Lindsay, Ounsted, & Richards, 1979).…”

Conversational Repair in Pediatric Epilepsy

“…In support of this hypothesis, we have shown that the severity of thought disorder in children with CPS and PGE is associated with age of onset, EEG evidence for frontotemporal localization of epileptic activity, seizure control, and IQ (Caplan et al, 1992a(Caplan et al, , 1994(Caplan et al, , 1997. Furthermore, EEG evidence for propagation of CPS from the temporal lobe to the ipsilateral and then contralateral frontal lobe (Lieb et al, 1991), seizure control related improvement on frontal lobe tasks after temporal lobectomy (Helmstaedter et al, 1998), as well as decreased perseveration on the Wisconsin Card Sorting test with seizure control after anterior temporal lobectomy (Hermann et al, 1995) suggest that uncontrolled CPS might be associated with frontal lobe dysfunction.…”