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A six-year longitudinal study of neurocognitive problems in children with epilepsy
Sofia Kasradze1, Giorgi Lomidze1, J Helen Cross2
1Institute of Neurology and Neuropsychology, 83/11, Vaja-Pshavela Ave., 0186 Tbilisi, Georgia; Caucasus International University, 73, Chargali Str., 0141 Tbilisi, Georgia.
Insights
Children with epilepsy (CH-E) often exhibit neuropsychological abnormalities, including impaired memory and motor skills. These deficits are linked to early seizure onset, epilepsy duration, and structural brain damage, necessitating cognitive function evaluation in epilepsy diagnosis.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Cognitive Psychology
Background:
- Epilepsy significantly impacts children's cognitive development.
- Neuropsychological deficits are common in children with epilepsy (CH-E).
Purpose of the Study:
- To identify specific neuropsychological abnormalities in children with epilepsy (CH-E) in Georgia.
- To explore predictors of cognitive impairment in CH-E.
Main Methods:
- A cohort study compared CH-E and children without epilepsy (CH-NoE), aged 6-13 years.
- Neurological, epileptological, and comprehensive neuropsychological assessments were conducted.
Main Results:
- CH-E frequently showed abnormalities in praxis, verbal functions, learning, visual-spatial skills, motor abilities, and memory.
- Early seizure onset, epilepsy duration, anti-seizure medication (ASM) use, and structural brain abnormalities predicted impaired cognitive functioning.
Conclusions:
- Over half of CH-E experience cognitive impairments, potentially exacerbated by ASM therapy and structural brain damage.
- Cognitive function evaluation is crucial for effective epilepsy management in children.
Introduction:
This study describes the specific neuropsychological abnormalities among children with epilepsy (CH-E) living in Georgia.
Methods:
A cohort of CH-E and children without epilepsy (CH-NoE), aged 6-13 years, admitted to the epilepsy center of the Institute of Neurology and Neuropsychology from 1st January 2010 to 31st December 2015, was selected and investigated with a structured protocol. Neurological/epileptological assessments were made and neuropsychological testing was done on all study subjects.
Results:
Abnormalities in praxis, verbal functions, verbal learning, visual-spatial matching, visual-motor ability, and fine motor skills, working memory, and phonological memory span were often revealed in CH-E as compared to CH-NoE. Early age of seizure onset, epilepsy duration, and anti-seizure medication (ASM) use, in combination with brain structural abnormalities on neuroimaging, and structural etiology were independent predictors of impaired functioning in various neuropsychological domains.
Discussion:
More than half of children with epilepsy have a variety of cognitive impairments, which may increase with ASM therapy, especially when the cause of seizures is structural damage to the brain. Therefore, in the process of diagnosing epilepsy, evaluation of cognitive functions should become an integral part to ensure effective management of the disorder.
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