Cognitive and behavioural findings in children with frontal lobe epilepsy
Hilde M H Braakman1, Dominique M Ijff, Maarten J Vaessen
1Department of Neurology, Maastricht University Medical Centre, P. Debyelaan 25, 6202 AZ Maastricht, The Netherlands. hilde.braakman@gmail.com
Insights
Children with frontal lobe epilepsy (FLE) experience significant cognitive and behavioral impairments, with high seizure frequency impacting specific cognitive skills. Further research into brain abnormalities is recommended.
Area of Science:
- Neurology
- Pediatrics
- Neuropsychology
Background:
- Frontal Lobe Epilepsy (FLE) is a common childhood epilepsy.
- Cognitive and behavioral impairments are known comorbidities in epilepsy.
- The extent of these impairments in pediatric FLE is not well understood.
Purpose of the Study:
- To assess cognitive skills and behavior in children with FLE.
- To identify potential correlations between epilepsy factors and neurocognitive outcomes.
Main Methods:
- Evaluated 71 children with cryptogenic FLE using intelligence and neuropsychological tests.
- Utilized behavioral questionnaires for assessment.
- Correlated performance with epilepsy onset, duration, seizure frequency, focus localization, and drug load.
Main Results:
- Pediatric FLE patients showed deficits in intellectual and neuropsychological functioning compared to norms.
- Visual-spatial skills, memory, psychomotor speed, and alertness were particularly affected.
- High seizure frequency correlated with lower arithmetic scores; other epilepsy factors showed no significant impact on cognitive tests. Behavioral issues included attention problems and anxiety, unrelated to epilepsy factors.
Conclusions:
- Children with cryptogenic FLE exhibit widespread cognitive and behavioral impairments.
- Seizure frequency may influence specific cognitive functions, but other epilepsy factors do not significantly affect cognition or behavior.
- Further investigation into underlying brain abnormalities is warranted.
Background:
Frontal Lobe Epilepsy (FLE) is the second most frequent type of partial epilepsy and its onset is generally in childhood. Though cognitive and behavioural impairments have been described as co-morbid disorders in epilepsy, their extent in FLE, particularly in children, remains unknown.
Aims:
In this study, we assess cognitive skills and behaviour in a cohort of paediatric FLE patients.
Methods:
We measured the performance of 71 children with cryptogenic FLE on intelligence tests, neuropsychological tests, and behavioural questionnaires. Age-dependent normative values were used for reference. Results were related to epilepsy-factors including age at epilepsy onset, duration of epilepsy, seizure frequency, localisation of the epileptic focus and drug load.
Results:
Paediatric FLE patients performed worse on intellectual and neuropsychological tests compared to reference values, and had a delay in school achievement. The performance of patients was typically worse on tasks measuring visual-spatial functions, memory, psychomotor speed and alertness. High seizure frequency was associated with lower scores on the arithmetic subtest of the intelligence scale; the other epilepsy-factors had no statistically significant influence on intelligence test or neuropsychological test outcome. Behavioural problems included attention problems, anxiety and internalising behaviour. These were not significantly related to epilepsy-factors.
Conclusions:
Children with cryptogenic FLE show a broad range of cognitive and behavioural impairments, compared to reference values. While high seizure frequency may affect performance on selected cognitive measures, other epilepsy-factors do not seem to influence cognition and behaviour. Study of micro-structural or functional brain abnormalities that underlie these cognitive and behavioural impairments are warranted.
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