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Neuropsychological status at seizure onset in children: risk factors for early cognitive deficits

P S Fastenau1, C S Johnson, S M Perkins

  • 1Department of Psychology, Indiana University, Purdue University, Indianapolis, USA. Philip.Fastenau@uhhospitals.org

Neurology
|August 14, 2009
PubMed

Insights

Neuropsychological deficits affect up to 40% of children with seizures, particularly those with risk factors like multiple seizures or antiepileptic drug use. Early evaluation is key for intervention.

Area of Science:

  • Pediatric Neurology
  • Neuropsychology
  • Epilepsy Research

Background:

  • Pediatric epilepsy is a common neurological disorder with potential long-term cognitive consequences.
  • Understanding early cognitive functioning in children with seizures is crucial for timely intervention.
  • Previous research has explored cognitive outcomes in epilepsy, but characterization at seizure onset is vital.

Purpose of the Study:

  • To characterize neuropsychological functioning and academic achievement in children experiencing their first recognized seizure.
  • To identify specific risk factors associated with cognitive deficits in this population.
  • To inform early intervention strategies for children with epilepsy.

Main Methods:

  • A prospective, community-based study comparing 282 children (ages 6-14, IQ ≥70) with a first seizure to 147 healthy siblings.
  • Utilized a battery of standardized neuropsychological and academic achievement tests.
  • Examined associations between cognitive outcomes and demographic/clinical variables.

Main Results:

  • In intellectually normal children, 27% with one seizure and up to 40% with risk factors showed neuropsychological deficits near seizure onset.
  • Risk factors for deficits included multiple seizures (OR=1.96), antiepileptic drug use (OR=2.27), symptomatic/cryptogenic etiology (OR=2.15), and epileptiform EEG (OR=1.90).
  • Absence epilepsy (OR=2.00) and having all four risk factors (OR=3.00) increased odds of neuropsychological impairment.

Conclusions:

  • A significant subgroup of intellectually normal children with seizures exhibit neuropsychological deficits at onset.
  • Academic achievement remained unaffected, highlighting a potential window for early intervention.
  • Identified risk factors necessitate prompt neuropsychological evaluation early in the epilepsy course.
Abstract

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