Investigating neuropsychological functions in pediatric epilepsy: a cross-sectional study

Children with epilepsy (CWE) face problems beyond seizures, including cognitive, emotional, and behavioral problems, impacting their development, academic achievements, and quality of life. This study evaluated neuropsychological functions using a broad test battery and explored associations with epilepsy-related variables in CWE aged six to 17 attending regular school. Secondarily, differences in neuropsychological functions between epilepsy subtypes were explored.

This cross-sectional study included 89 CWE from two outpatient pediatric clinics in Denmark. Neuropsychological performance was assessed by trained neuropsychologists using standardized tests. Subtests were grouped into eight domains: Intelligence, memory and learning, attention, working memory, fluency, processing speed, planning and shifting as key executive functions, and affect recognition.

CWE showed impaired neuropsychological performance compared to normative means across multiple domains, exemplified by intelligence (mean z: -0.59, 95% CI= -0.81, -0.38). Similar impairments were observed in several other domains. No significant correlation was found between age at epilepsy onset and neuropsychological performance. Sex, epilepsy onset before 10 years, and the number of antiseizure medications were not associated with performance below the normative mean. No significant differences were observed between epilepsy groups.

Our results indicate that CWE attending outpatient clinics and regular schools have a broad spectrum of neuropsychological problems.