Neuropsychological assessment of children with epilepsy and average intelligence using NEPSY II

Many studies have shown altered neuropsychological functioning of children with epilepsy even in the absence of intellectual disability, with notable concerns for both patients and their families. Although studies have described the cognitive profiles associated with specific epilepsy syndromes, there is incomplete agreement on the relation between spared and impaired abilities in different cognitive domains and on how deficits in one neuropsychological ability can secondarily affect performance in other cognitive domains. The aim of this study was to investigate the neuropsychological profile and vulnerabilities of children with epilepsy without intellectual disability or borderline intellectual functioning.

23 children aged 7-15 years, with a diagnosis of epilepsy of genetic or unknown cause and average intellectual functioning (IQ >85), were administered all age-appropriate tests of the Italian-language version (Urgesi, Campanella, & Fabbro, 2011) of a comprehensive neuropsychological battery (NEPSY-II: A Developmental Neuropsychological Assessment, Second Edition; Korkman, Kirk, & Kemp, 2007). Their performance was compared with that of a control group matched for gender, age, handedness and education.

Children with epilepsy showed significant impairments as compared to the control group in tests of attention and executive functions and sensorimotor skills. Notably, particular difficulties were observed also in social perception tasks that require affect recognition, an ability that has been so far poorly considered in children with epilepsy.

The results highlight the importance of performing extensive evaluation of cognitive functions, including social cognition processes, in children with epilepsy with average intelligence in order to design appropriate interventions aimed at minimizing long-term consequences on educational and behavioral outcome.