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[Are idiopathic generalized epilepsies of childhood really benign?]
B Echenne1, R Cheminal, A Roubertie
1Service de Neuropédiatrie, Hôpital Saint-éloi, Montpellier, France.
Insights
Many childhood epilepsies, often deemed "benign," actually cause cognitive impairment and school difficulties. These findings challenge the notion that idiopathic generalized epilepsies are always mild, impacting learning and development.
Area of Science:
- Pediatric Neurology
- Developmental Psychology
- Epileptology
Background:
- Idiopathic generalized epilepsies (IGEs) are frequently considered benign in childhood.
- However, cognitive and academic challenges may be underestimated in these conditions.
Purpose of the Study:
- To investigate cognitive impairments and school difficulties in children with IGEs.
- To evaluate the appropriateness of the term "benign" for these epilepsy types.
Main Methods:
- Literature review and personal investigations were conducted.
- A controlled study assessed cognitive function (WISC III IQ scores, memory) and school performance in typical absence epilepsy.
Main Results:
- Children with typical absence epilepsy showed impaired non-verbal and total IQ scores.
- Significant memory deficits, delayed school progress, motor skill and alertness issues, and attention disorders were observed in 35-50% of cases.
- Most children experienced varying degrees of school difficulties.
Conclusions:
- The term "benign" is inappropriate for many idiopathic generalized epilepsies.
- Cognitive and academic impairments are prevalent, necessitating targeted interventions and support.
Abstract:
Most of the idiopathic generalized epilepsies are considered as benign in childhood. Using literature data and some personal investigations, we screened the cognitive impairment and school difficulties observed in children with idiopathic generalized epilepsies, especially absence epilepsies, myoclonic epilepsies considered as non-severe, and generalized epilepsies with tonico-clonic seizures. In a controlled study concerning typical absence epilepsy, we have shown a lack of high or moderately elevated level of non-verbal and total IQ scores on Wechsler's tests (WISC III); we also observed a significant impairment of memory, a lengthening of school realisations, concerning motor skills and alertness and also hyperactivity and/or attention disorders, concerning 35 to 50% of cases. Most of these children present with school difficulties, of variable degree. These results show that the term "benign" is not appropriate in many cases of so-called benign idiopathic generalized epilepsies.