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Cognition in pediatric patients with diagnosis of epilepsy
Arturo García-Galicia1, Alejandra Aréchiga-Santamaría2, Blanca Estela Cruz-Cruz1
1Instituto Mexicano del Seguro Social, Centro Médico Nacional "Manuel Ávila Camacho", Hospital de Especialidades de Puebla, Dirección de Educación e Investigación en Salud. Puebla, Puebla, México.
Insights
Pediatric epilepsy impacts cognition, with working memory most affected, particularly in adolescents. Cognitive deficits correlate with the duration of epilepsy, highlighting the need for early intervention.
Area of Science:
- Neurology
- Pediatric Neurology
- Cognitive Neuroscience
Context:
- Epilepsy affects 0.5-1% of children globally, often leading to cognitive impairments.
- Pediatric epilepsy presents unique challenges in cognitive development and academic performance.
- Understanding cognitive profiles is crucial for managing epilepsy in children and adolescents.
Purpose:
- To evaluate the cognitive characteristics of pediatric patients diagnosed with epilepsy.
- To identify specific cognitive domains affected by epilepsy in children and adolescents.
- To explore the relationship between epilepsy duration and cognitive function.
Summary:
- A cross-sectional study analyzed 95 pediatric epilepsy patients (ages 6-16) using the Wechsler Intelligence Scale IV.
- Results indicated a mean intellectual quotient of 90.3, with 12.6% of patients showing decreased scores.
- Working memory was the most affected cognitive domain (31.6%), especially in adolescents (40%), and correlated with epilepsy duration.
Impact:
- Identifies working memory as a key cognitive domain impacted by pediatric epilepsy, particularly in adolescents.
- Demonstrates a significant correlation between epilepsy duration and deficits in working memory and perceptual reasoning.
- Informs clinical practice regarding targeted cognitive assessments and interventions for pediatric epilepsy patients.
Background:
Epilepsy affects from 0.5 to 1% of children worldwide and has a cognitive impact on the patient.
Objective:
To assess cognitive characteristics in pediatric patients diagnosed with epilepsy.
Material And Methods:
Analytical, cross-sectional study of patients with epilepsy aged 6 to 16 years in a tertiary hospital in Puebla, Mexico. Type of epilepsy, evolution, treatment, and school performance were evaluated. The Wechsler Intelligence Scale IV was used for cognitive characteristics. Mann-Whitney U and phi coefficients were used. It was considered statistically significant a p < 0.05.
Results:
95 patients were included, 61.1% were male. Mean: age 11.16 years (± 2.5), school performance 7.8 (± 0.99), time of development: 2.4 years (± 1.4). They were schoolchildren aged 6-11 years (36.8%) and adolescents aged 12-16 years (63.2%); 79% had generalized epilepsy; 93.6% were treated with monotherapy (47.3% with magnesium valproate). The mean intellectual quotient was 90.3 (± 10.02), decreased in 12 patients (12.6%). Working memory was the most commonly affected domain (31.6%), mostly in adolescents with 40% (p = 0.021). Perceptual reasoning and working memory were significantly correlated with developmental time (phi = 0.17, p = 0.04 and phi = 0.49, p < 0.001, respectively).
Conclusions:
Working memory was the most affected cognitive characteristic, especially in adolescents. Working memory and perceptual reasoning were affected by time of development.
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