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The impact of childhood epilepsy on neurocognitive and behavioral performance: a prospective longitudinal study
1The Nemours Children's Clinic, Jacksonville, Florida 32207, USA. lbailet@nemours.org
Insights
Children with epilepsy (CWE) and migraine (CWM) face higher risks of learning problems than controls. Neurocognitive screening is vital for assessing academic risk in CWE, as medical factors are elusive predictors.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Developmental Psychology
Background:
- Children with idiopathic epilepsy (CWE) and children with migraine (CWM) are compared to sibling controls.
- Previous research suggests potential cognitive and behavioral challenges in these pediatric populations.
- Understanding these challenges is crucial for early intervention and academic support.
Purpose of the Study:
- To evaluate neurocognitive and behavioral performance in children with idiopathic epilepsy (CWE), their siblings, and children with migraine (CWM).
- To identify medical factors associated with learning or behavioral difficulties in CWE.
- To establish a baseline for long-term academic risk assessment in children with epilepsy.
Main Methods:
- A cohort of 74 children with idiopathic epilepsy (CWE), 23 sibling controls, and 13 children with migraine (CWM) aged 8-13 years with IQs ≥80 participated.
- Annual neurocognitive testing was conducted for up to 3 years.
- For CWE, data on seizure onset, EEG, seizure type/frequency, and antiepileptic drug (AED) use were collected.
Main Results:
- CWE and CWM exhibited higher rates of grade retention and special education placement than controls.
- CWE showed persistent neurocognitive deficits compared to controls, even with normal IQs.
- Abnormal EEGs in CWE correlated with lower reading and spelling scores; AED type (carbamazepine vs. valproate) showed a potential, though unconfirmed, academic performance difference.
Conclusions:
- Children with epilepsy face a significant long-term risk of learning problems, irrespective of seizure control or IQ.
- Predicting learning difficulties in CWE using medical factors remains challenging.
- Regular neurocognitive screening and educational monitoring are recommended for identifying academic risks in CWE.
Purpose:
To assess neurocognitive and behavioral performance in children with idiopathic epilepsy (CWE, n = 74), their siblings without epilepsy (control, n = 23), and children with migraine (CWM, n = 13), and to identify medical factors related to learning or behavioral problems in CWE.
Methods:
Subjects, ages 8-13 years with IQs of >/=80, completed a neurocognitive test battery annually for
Results:
CWE and CWM had high rates of grade retention and placement in special education compared with sibling controls. CWE performed worse than controls on numerous neurocognitive variables. These differences persisted over time. CWE with abnormal EEGs scored lower than CWE with normal EEGs on reading and spelling measures, even with comparable IQs. Age at seizure onset, seizure type, and seizure frequency were not related to neurocognitive or behavioral test scores. CWE taking carbamazepine (CBZ) performed better than CWE taking valproate (VPA) on academic achievement measures, although the study lacked controls necessary to assess this finding thoroughly. CWM did not differ from CWE or controls in cognitive or academic achievement skills.
Conclusions:
Long-term risk of learning problems exists among CWE as compared with controls, even with normal IQs and well-controlled seizures. Predicting learning problems in CWE based on medical factors remains elusive. Monitoring of educational progress and neurocognitive screening may be most effective in assessing academic risk for CWE.