Learning Disorders in Epilepsy

Abstract

Summary: Learning disorders (LD) are disorders interfering with academic performance or with daily living activities requiring reading, writing, or mathematical abilities in subjects with a normal intelligence quotient. The prevalence of LD in the general population has been found to be 2-10% and reading disorders are the most frequent subtype. Epilepsy is one of the commonest neurological disorders in childhood with an estimated prevalence in 4-5/1,000. Epilepsy is considered to be idiopathic or cryptogenic in approximately two-thirds of cases. LD are more common in people with epilepsy than in the general population: about 25% of patients with epilepsy are said to have LD. Various psychosocial, medication-related, and epilepsy-related factors may be associated with LD in epilepsy. LD can be either permanent or state-dependent. Permanent LD are caused by a brain lesion and/or a stable brain dysfunction. In contrast, state-dependent LD are potentially reversible and treatable; they are caused by epilepsy-related factors. If allowed to persist for a long period, a state-dependent LD may become permanent.

The effects of antiepileptic drugs on classroom performance

“…However, due to the frequent temporal relation between the onset of seizures and the initiation of AEDs, it is also important to consider whether the seizures themselves are creating learning problems. For instance, ictal and periictal phenomena (i.e., cognitive and/or behavioral alterations that occur during or after a seizure) may create more state-dependent learning problems, such as altered awareness, confusion, or disorientation (Beghi, Corrnaggia, Frigeni, & Beghi, 2006). Depending upon the type of seizures a child may be having, postictal changes can also affect performance in the classroom by disrupting attention, language processing, speech production, and/or motor coordination or strength for a period of time after the seizure.…”

Psychiatric issues in chronically ill adolescents

“…Even when excluding children and adolescents who have combined mental retardation and seizure disorders, about 25% of those with epilepsy alone will have a LD, the most common of which involves reading (25).…”

Comorbidities of Refractory Epilepsy and the Update Mechanism

“…A community-based study showed that children with epilepsy had lower overall cognition function than those without [11], whereas another study revealed onset age <5 years and symptomatic epilepsy were associated with low cognition function [12]. In aspect of associated learning disorders, they are often found at the onset, and always described as subtle, consequently, difficult to recognize.…”

“…Both working memory and processing speed are sensitive markers of impaired learning function, can be used as a screening tool for learning disorders [13]. Regardless of AED use, underlying syndrome and remission status, children with epilepsy often have unsatisfied performance in writing, reading and mathematics, even they are within normal range of IQ [11,14]. Generalized epilepsy is often giving a worse performance in arithmetic test than focal epilepsy [15].…”