Neuropsychological Abilities of Children with Epilepsy

Abstract

One hundred eighteen epileptic children, aged 6-15 years, underwent detailed neuropsychological testing including the Wechsler Intelligence Scale for Children-Revised and the age-appropriate Halstead-Reitan battery. Eight had classical absence seizures only, eight had classic absence seizures and generalized tonic-clonic seizures, 30 had generalized tonic-clonic seizures only, 31 had partial seizures only, 20 had partial seizures and generalized seizures, 15 had atypical absence seizures, and five had minor motor seizures. A control group of 100 children without seizures, matched to the general population for intelligence and matched to the seizure cases for age, underwent identical testing. The Wechsler full-scale intelligence quotient (FSIQ) of cases was significantly (p = 0.01) lower than that of controls and was related to seizure type. Children with minor motor or atypical absence seizures had the lowest average FSIQ (70 and 74, respectively). All seizure types were associated with below-control intelligence except classic absence only. Intelligence was also correlated with degree of seizure control. A highly significant inverse correlation between years with seizures and intelligence was found (p less than 0.0001). A rating of neuropsychological impairment, derived from all measures of brain function, was assigned to each child. Epileptic children had significantly more impairment than controls (p less than 0.0001). Children with seizures had been placed in special education or had repeated a grade in school almost twice as frequently as controls (p less than 0.001). Even though often placed in a class of younger children, their academic achievement was behind grade placement more often than in controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Neuropsychological Functions in Idiopathic Occipital Lobe Epilepsy

“…Many studies of cognitive function in children with epilepsy have shown that their mean test scores were below that of the particular test used (21)(22)(23) and that even children with epilepsy but with no known neurologic disorder obtained lower IQ scores (24,25). Although it has been reported that children with epilepsy might have normal IQs (26) or that their IQs were not significantly different from controls (27), neuropsychological defects are not rare in children with idiopathic epilepsy who have normal IQs (26,(28)(29)(30).…”

Cognitive Effects of “Older” Anticonvulsants in Children with Epilepsy: A Review and Critique of the Literature

“…2,3 The great variability in the academic achievement and neuropsychological functioning of children with epilepsy relates to many factors, including seizure type, severity and frequency of seizures, level of control of the seizures achieved through treatment, age of onset, and the effect of anticonvulsant medications.…”

“…A list of commonly used cognitive tasks and the areas of cognition they measure can be found in Table 1. The degree of impairment or lack thereof in children with epilepsy has been shown to be mediated by numerous factors, including age of onset, 1,2 seizure type, 1 duration of the seizure disorder, 1 the presence versus absence of visible underlying pathology, 3 responsiveness of seizure activity to treatment, 2,4 and the choice and amount of pharmacologic treatment used. 1,5 Because of the multitude of factors thought to contribute to cognitive decline of children with seizure disorders, it is often difficult to systematically investigate the effects of one factor while controlling for other variables.…”

“…8 No. 2 • www.ppag.org Ries M pose. Knowledge regarding the cognitive effects of these medications allows practitioners and parents to make informed decisions regarding which anticonvulsant should be prescribed.…”

Impact of Plasmodium falciparum malaria on performance and learning: review of the evidence

“…30 These children are also at a significantly increased risk of impairment in intellectual functions (ϳ3 times more likely to score outside normal limits on IQ tests and to develop a range of social and educational difficulties). [31][32][33] The experience of one episode of status epilepticus has been shown to lead to cognitive sequelae (defined as IQ Ͻ 80) in ϳ30% of cases. 34 Temporal lobe epilepsy has been particularly associated with impairments of language and memory function and with behavioral disorders.…”