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Specific cognitive dysfunction in children with epileptic mothers
E Gaily1, E Kantola-Sorsa, M L Granström
1Child Neurology Department, Children's Castle Hospital, Helsinki, Finland.
Insights
Children of mothers with epilepsy showed specific cognitive deficits, particularly in visual-spatial skills and auditory processing. These cognitive issues were linked to maternal seizures and paternal education, not anti-epileptic drug exposure.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Epilepsy in mothers can impact child development.
- Children of epileptic mothers may be exposed to anti-epileptic drugs (AEDs) or maternal seizures during pregnancy.
Purpose of the Study:
- To investigate cognitive and motor function in children aged 5.5 years whose mothers have epilepsy.
- To identify risk factors associated with cognitive dysfunction in this cohort.
Main Methods:
- Compared 104 children of epileptic mothers with 105 control children of normal intelligence.
- Assessed specific cognitive abilities using the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI) block design and the Illinois Test of Psycholinguistic Abilities (ITPA) auditory closure.
Main Results:
- Children of epileptic mothers performed significantly worse on block design and auditory closure tasks.
- A higher prevalence of specific cognitive dysfunction was observed in children exposed to maternal epilepsy.
- Risk factors included maternal partial seizures, seizures during pregnancy, and low paternal education; AED exposure was not a significant factor.
Conclusions:
- Maternal epilepsy, particularly seizures during pregnancy, is associated with specific cognitive deficits in offspring.
- Potential mechanisms include fetal asphyxia, genetic factors, or psychosocial disadvantage.
- Cognitive outcomes in children of epileptic mothers warrant further investigation beyond AED exposure.
Abstract:
Specific cognitive abilities and motor function were investigated at 5.5 years in 104 children with epileptic mothers and in 105 control children, all with normal general intelligence. The majority (89 per cent) of the children of epileptic mothers had been exposed to anti-epileptic drugs during pregnancy, most commonly phenytoin (69 per cent). Maternal seizures had occurred during pregnancy in 52 per cent. A significant difference, with poorer performance in the study group, was found in block design (WPPSI) and auditory closure (ITPA). Significantly more study than control children had some type of specific cognitive dysfunction. Within the study group, increased risk was associated with maternal partial seizures, with seizures occurring during pregnancy, and with low paternal education, but not with exposure to anti-epileptic drugs. Three possible mechanisms of this effect are suggested: subtle brain-damage associated with fetal asphyxia during the mothers' generalized convulsions; genetically transmitted brain abnormalities; and psychosocial disadvantage limiting partner choice.