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When Epilepsy Grows Up….

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    Childhood neurocognitive impairment in epilepsy significantly increases mortality risk over 50 years. Lower cognitive function also reduces the likelihood of achieving complete seizure remission.

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    Area of Science:

    • Neurology
    • Pediatrics
    • Epilepsy Research

    Background:

    • Childhood-onset epilepsy can have long-term consequences beyond seizures.
    • Neurocognitive function is a critical aspect of development and long-term outcomes.

    Purpose of the Study:

    • To investigate the association between childhood neurocognitive impairment and long-term mortality.
    • To examine the relationship between childhood neurocognitive status and complete seizure remission over 50 years.

    Main Methods:

    • A population-based cohort of 245 individuals with childhood-onset epilepsy was followed for up to 50 years.
    • Neurocognition was assessed using IQ scores and functional criteria before age 18.
    • Mortality and 10-year terminal seizure remission were analyzed using Cox regression.

    Main Results:

    • 49% had normal childhood neurocognition, 51% had impairment.
    • Mortality was significantly higher in those with impaired neurocognition (44%) compared to normal (13%).
    • Increased neurocognitive impairment correlated with higher mortality risk and lower rates of seizure remission.

    Conclusions:

    • Severity of childhood neurocognitive impairment is directly associated with increased long-term mortality risk.
    • Impaired neurocognition in childhood epilepsy is linked to a reduced chance of achieving complete seizure remission.
    • Normal neurocognition does not preclude premature death or guarantee seizure remission in all individuals.