Seizure-related factors and non-verbal intelligence in children with epilepsy. A population-based study from Western
B Høie1, A Mykletun, K Sommerfelt
1Department of Pediatrics, Haukeland University Hospital, 5021 Bergen, Norway. bjorg.hoie@ulleval.no
Insights
Seizure-related factors, not socioeconomic status, impact non-verbal intelligence in children with epilepsy. Specific seizure types and early onset are linked to severe non-verbal problems (SNVP), while others are not.
Area of Science:
- Neurology
- Pediatrics
- Neuropsychology
Background:
- Epilepsy in children can affect cognitive development.
- Understanding factors influencing non-verbal intelligence is crucial for tailored interventions.
Purpose of the Study:
- To investigate the relationship between seizure characteristics, non-verbal intelligence, and socioeconomic status (SES) in children with epilepsy.
- To identify specific seizure-related factors associated with severe non-verbal problems (SNVP).
Main Methods:
- A population-based sample of 198 children (6-12 years) with epilepsy and 126 healthy controls were assessed.
- International League Against Epilepsy (ILAE) classifications were used for seizure and syndrome categorization.
- Non-verbal intelligence was evaluated using Raven matrices, with SNVP defined as scores at or below the 10th percentile.
Main Results:
- Children with epilepsy showed a higher prevalence of SNVP (43%) compared to controls (3%).
- SNVP were more common in epilepsy with remote symptomatic aetiology, undetermined syndromes, myoclonic seizures, early onset, frequent seizures, and polytherapy.
- Idiopathic epilepsies, localization-related cryptogenic epilepsies, absence/simple partial seizures, and late onset were not significantly associated with SNVP.
Conclusions:
- Seizure-related factors, not SES, are associated with SNVP in childhood epilepsy.
- SNVP are particularly prevalent in complex, therapy-resistant epilepsies and those with early onset.
- Findings aid in developing individualized therapy strategies for children with epilepsy based on cognitive profiles and seizure characteristics.
Purpose:
To study the relationship between seizure-related factors, non-verbal intelligence, and socio-economic status (SES) in a population-based sample of children with epilepsy.
Methods:
The latest ILAE International classifications of epileptic seizures and syndromes were used to classify seizure types and epileptic syndromes in all 6-12 year old children (N=198) with epilepsy in Hordaland County, Norway. The children had neuropediatric and EEG examinations. Of the 198 patients, demographic characteristics were collected on 183 who participated in psychological studies including Raven matrices. 126 healthy controls underwent the same testing. Severe non-verbal problems (SNVP) were defined as a Raven score at or <10th percentile.
Results:
Children with epilepsy were highly over-represented in the lowest Raven percentile group, whereas controls were highly over-represented in the higher percentile groups. SNVP were present in 43% of children with epilepsy and 3% of controls. These problems were especially common in children with remote symptomatic epilepsy aetiology, undetermined epilepsy syndromes, myoclonic seizures, early seizure debut, high seizure frequency and in children with polytherapy. Seizure-related characteristics that were not usually associated with SNVP were idiopathic epilepsies, localization related (LR) cryptogenic epilepsies, absence and simple partial seizures, and a late debut of epilepsy. Adjusting for socio-economic status factors did not significantly change results.
Conclusions:
In childhood epilepsy various seizure-related factors, but not SES factors, were associated with the presence or absence of SNVP. Such deficits may be especially common in children with remote symptomatic epilepsy aetiology and in complex and therapy resistant epilepsies. Low frequencies of SNVP may be found in children with idiopathic and LR cryptogenic epilepsy syndromes, simple partial or absence seizures and a late epilepsy debut. Our study contributes to an overall picture of cognitive function and its relation to central seizure characteristics in a childhood epilepsy population and can be useful for the follow-up team in developing therapy strategies that meet the individual needs of the child with epilepsy.
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