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Psychological effects of subclinical epileptiform EEG discharges in children. II. General intelligence tests
B M Siebelink1, D J Bakker, C D Binnie
1Department of Child Neuropsychology, Free University, Amsterdam, The Netherlands.
Insights
Subclinical epileptiform discharges in children with epilepsy can temporarily impair cognitive function, particularly verbal short-term memory. This suggests intermittent cognitive deficits may be linked to EEG abnormalities, not just static conditions.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Cognitive Psychology
Background:
- Epilepsy in children is often associated with cognitive impairments.
- The role of subclinical epileptiform discharges in cognitive function remains unclear.
- Previous research has not fully elucidated the intermittent impact of EEG abnormalities on cognition.
Purpose of the Study:
- To investigate the impact of subclinical epileptiform electroencephalogram (EEG) discharges on cognitive performance in children with epilepsy.
- To determine if cognitive deficits are static or intermittent, related to the occurrence of EEG discharges.
- To explore the relationship between specific EEG discharge patterns and performance on cognitive tasks.
Main Methods:
- Studied 21 children with epilepsy and subclinical EEG discharges during a general intelligence test (RAKIT).
- Utilized telemetered EEG and closed-circuit television for behavior recording during testing.
- Analyzed performance on 6 subtests, focusing on verbal short-term memory and the timing of EEG discharges.
Main Results:
- Children with epilepsy showed lower mean total IQ scores compared to control populations.
- Cognitive performance was impaired, particularly in verbal short-term memory, in children exhibiting discharges during testing.
- Performance on specific subtests was negatively affected when discharges occurred during test item presentation or response phases.
Conclusions:
- Cognitive impairment in epilepsy may be partly an intermittent process linked to subclinical epileptiform discharges.
- Findings suggest a need to reconsider the interpretation of neuropsychological studies in epilepsy.
- Implications for drug treatment strategies in epilepsy patients with controlled seizures but persistent subclinical EEG discharges.
Abstract:
Twenty-one children with suspected or proven epilepsy and subclinical epileptiform EEG discharges in the waking state were studied. The EEG was telemetered and behaviour recorded by closed-circuit television during performance of a general intelligence test (RAKIT, shortened version) which comprised 6 subtests. Mean total IQ was below that of control populations and the subtests profile was abnormal, due particularly to impaired performance on a subtest concerned with verbal short-term memory. This effect was accounted for by that subgroup of children who exhibited discharges during the test; those who did not show discharges at that time were unimpaired. Performance of 3 of the subtests was impaired when discharges occurred during presentation of the test item or between presentation and response. The findings suggest that cognitive impairment found in people with epilepsy may not only represent a more or less static disability, due to drugs, cerebral pathology, etc., but may in part be an intermittent process related to the occurrence of subclinical epileptiform discharges. These preliminary findings need to be amplified but have implications both for interpretation of neuropsychological studies in persons with epilepsy and also for the drug treatment of those who continue to exhibit subclinical EEG discharges when overt seizures have been controlled.