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Cognitive development in benign focal epilepsies of childhood
M N Metz-Lutz1, C Kleitz, A de Saint Martin
1INSERM U 398, Clinique Neurologique, Hôpitaux Universitaires de Strasbourg, France. metzlutz@neurochem.u-strasbg.fr
Insights
Benign focal epilepsy of childhood (BFEC) can impact learning and behavior. Cognitive deficits, especially non-verbal, correlate with seizure frequency and right-hemisphere focus in children with BFEC.
Area of Science:
- Pediatric Neurology
- Developmental Neuroscience
Background:
- Benign focal epilepsy of childhood (BFEC) is common in children aged 3-12.
- While epilepsy prognosis is favorable, learning and behavioral issues are increasingly reported.
Purpose of the Study:
- To investigate electroclinical and neuropsychological changes in children with BFEC.
- To explore correlations between epilepsy characteristics and cognitive performance.
Main Methods:
- Prospective study of 22 children with BFEC.
- 18-month follow-up including electroclinical and neuropsychological assessments.
Main Results:
- Cognitive deficits, primarily non-verbal, correlated with seizure frequency and spike-wave discharge intensity.
- Right-hemisphere epileptic foci were associated with more pronounced non-verbal deficits.
- Frontal functions (attention, organization, motor speed) were impaired in active BFEC, irrespective of focus lateralization.
Conclusions:
- Epilepsy in childhood can interfere with cognitive functions, even those distant from the epileptic focus.
- Seizure activity and focus lateralization are key factors in cognitive outcomes for children with BFEC.
Abstract:
Benign focal epilepsy of childhood (BFEC) is the most common form of epilepsy, in children from 3 to 12 years. Its prognosis is always favourable as far as the epilepsy is concerned. Nevertheless, recent clinical data suggest that children affected by BFEC are more likely to show learning difficulties and behavioural disturbances than their peers. We report here the preliminary findings of a prospective study of 22 children affected with BFEC. Electroclinical and neuropsychological changes observed during the first 18 months of the follow-up strengthen the conclusion of recent neuropsychological studies stressing the correlation between epilepsy and cognitive performances. The cognitive deficits affecting mainly non-verbal functions were significantly correlated with the frequency of seizures and spike-wave discharges and to the lateralization of the epileptic focus in the right hemisphere, whereas frontal functions like attention control, response organization and fine motor speed, were impaired in the presence of active BFEC independently of the lateralization of the epileptic focus. Our results indicate that maturing cognitive functions subserved by a cortical area distant from the epileptic focus are susceptible to interference with epilepsy.