Seizure-related variables are predictive of attention and memory in children with epilepsy
Danielle N Lordo1, Ryan Van Patten1, Eliana L Sudikoff1
1Saint Louis University, Department of Psychology, 3700 Lindell Blvd., St. Louis, MO 63108, United States.
Insights
Children with epilepsy (CWE) face higher risks for attention and memory issues. Longer seizure duration and more anti-epileptic drugs (AEDs) significantly impact cognitive function in these children.
Area of Science:
- Pediatric Neurology
- Neuropsychology
- Epilepsy Research
Background:
- Children with epilepsy (CWE) exhibit increased risks for cognitive and behavioral challenges compared to healthy peers.
- Specific seizure characteristics and treatments may exacerbate these risks.
Purpose of the Study:
- To investigate the association between seizure-related variables and attention/memory functioning in CWE.
- To differentiate the impact of seizure variables from sociodemographic factors on cognitive performance.
Main Methods:
- Retrospective analysis of medical charts from 207 children (ages 6-16) with epilepsy.
- Utilized neurocognitive assessments and parent/teacher reports.
- Employed hierarchical multiple regressions to analyze sociodemographic and seizure-related variables.
Main Results:
- Seizure-related variables significantly predicted poorer cognitive performance, independent of sociodemographic factors.
- Longer lifetime seizure duration and a higher number of anti-epileptic drugs (AEDs) were strong predictors of attention and memory deficits.
- Seizure variables showed minimal predictive value for parent/teacher-reported outcomes.
Conclusions:
- CWE experiencing prolonged seizures and polypharmacy (multiple AEDs) are at heightened risk for attention and memory impairments.
- Identifying these risk factors aids clinicians in precise treatment planning and family guidance.
- This research underscores the importance of managing seizure burden and medication load to mitigate cognitive risks in children with epilepsy.
Abstract:
Children with epilepsy (CWE) are at greater risk for cognitive deficits and behavioral difficulties than are typically developing healthy children, and particular epileptic symptoms and treatments may contribute to this risk. The current study examined the relationships between four seizure-related variables and attention and memory functioning in a sample of 207 CWE (ages 6-16) using both neurocognitive and parent/teacher-report measures. Sociodemographic, medical, and neuropsychological data were collected from patients' medical charts in a retrospective fashion. Hierarchical multiple regressions were performed with sociodemographic variables (age, gender, race) entered as step one and seizure-related variables (number of anti-epileptic drugs [AEDs], EEG laterality, EEG lobe of focus, lifetime seizure duration) entered as step two. Results indicated that seizure-related variables were consistently predictive of poor cognitive performances above and beyond sociodemographic variables, although only minimally predictive of parent/teacher-reports. A longer duration of seizure burden and greater number of AEDs were robust predictors of performances on most cognitive measures. These findings indicate that CWE with long lifetime seizure durations and multiple AEDs are at risk for inefficiencies in attention and memory. Knowledge of this risk will allow treating providers greater accuracy and precision when planning medical treatment and making recommendations to families.
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