Assessing cognitive impairment among pediatric epilepsies: a systematic review

Epilepsy is a chronic neurological disorder that varies both for etiopathology and impact on cognitive, intellectual, and adaptive development in children with epilepsy (CWE). CWE may present with reduced attention, memory as well as learning skills, and impaired executive and emotional-behavioral functioning, which can impact both the patient's and their family's Quality of Life (QoL).

This systematic review investigates the tools and scales used to assess cognition in CWE, following the PRISMA guidelines. PubMed was used as primary source database and studies published between January 2020 and December 2024 were reviewed for inclusion/exclusion criteria.

The authors' search yielded 3,398 articles of which 2,486 (73%) papers were excluded based on title and abstract only. Of the 912 remaining records, 844 did not meet the inclusion criteria. Sixty-eight studies met the inclusion criteria. The total number of epilepsy patients (EP) in the included studies was 4,530. The Wechsler intelligence scale for children was the most administered test to evaluate cognitive impairment.

The included studies highlighted the relevance of the impaired neuropsychological functioning in CWE, although deep heterogeneity in the assessment still invalidates comparability. Further research is needed to provide comprehensive care of CWE, enhancing cognitive functions and considering the impact of the illness on QoL and mental health.