Longitudinal Assessment of Neuropsychologic and Language Function in Children with Benign Rolandic Epilepsy

Abstract

Previous studies of benign rolandic epilepsy have reported improvement in cognitive functioning over time. Their focus was the impact of paroxysmal electroencephalographic (EEG) activity on neuropsychologic function. Comprehensive longitudinal language assessment has not previously been undertaken. In a cross-sectional study, we demonstrated that some children with benign rolandic epilepsy have difficulties in verbal and visual memory and phonologic awareness. The current study evaluated a subgroup longitudinally to determine if difficulties improved. Twenty-eight patients underwent comprehensive longitudinal neuropsychologic and language assessments. The clinical features evaluated included seizure frequency, absolute age, medications, and a follow-up EEG. Differences in performance were analyzed using t-tests. Improvement in cognitive functioning, particularly in the areas of verbal memory, receptive language ability, and phonemic manipulation, was demonstrated. Visual memory and aspects of phonologic awareness showed no change. The improvements were not related to the clinical variables. It is important to recognize cognitive difficulties in children with benign rolandic epilepsy. Some difficulties can resolve; however, continued monitoring, particularly in areas of visual memory and phonologic awareness, is required.

Cognitive Progression in Epilepsy

“…Northcott et al (2006) reported that there was no difference in cognitive change as a function of medication (on versus off) in their sample of BRE subjects. The remaining studies did not report on seizure-cognitive change relationships or reported in a way that made the findings unclear (i.e., no formal statistical analyses).…”

“…These studies consistently indicated improvement in cognitive performance over the test-retest interval (Lindgren et al 2004;Northcott et al 2006). Benign rolandic epilepsy is considered an idiopathic seizure disorder characterized by nocturnal tonic-clonic seizures and daytime partial seizures.…”

“…Furthermore, most studies failed to use an age-matched control group. Only one study directly reported on the relationship between chronological age and cognitive change over the test-retest interval, and it produced mixed findings (Northcott et al 2006).…”

Neuropsychological Deficits in Childhood Epilepsy Syndromes

“…Twenty-eight participants underwent reevaluation, and differences were evaluated via t-tests. Improvement was observed in verbal memory and receptive language, whereas visual memory performance and phonological awareness did not improve (Northcott et al 2006).…”

Electroencephalographic Abnormalities in Non-epileptic Children with Attention-Deficit /Hyperactivity Disorder

“…Some children with ADHD with rolandic spikes have been reported to demonstrate deficient inhibition of an ongoing response and decreased interference control causing increased impulsivity and deterioration in the course of ADHD [22]. Other studies have reported that children with rolandic spikes have difficulties in visual-spatial memory, phonologic awareness and delayed academic performance [23,24]. Although rolandic spikes have been reported to be one of the most common EEG abnormalities in children with ADHD and to be a cause of cognitive impairment, the mechanism between rolandic spikes and ADHD remains unclear.…”