Cognitive disengagement syndrome and learning difficulty symptoms in children with epilepsy: A case-control study

Cognitive Disengagement Syndrome (CDS) is an attentional construct characterized by excessive daydreaming, mental fogginess, and slowed behavior. This study examined CDS/SCT symptoms and their association with learning difficulties in children with epilepsy.

In this cross-sectional case-control study, 400 children aged 6-16 years (200 with epilepsy, 200 healthy controls) were assessed using the WISC-R, Turgay DSM-IV Scale, Barkley Child Attention Survey, and Specific Learning Difficulty Symptom Scale.

Children with epilepsy demonstrated significantly higher CDS scores than controls (18.28 ± 5.47 vs. 16.36 ± 5.34; p < 0.001; g = 0.36) and lower IQ scores (95.0 ± 7.9 vs. 97.0 ± 6.1; p = 0.004; g = 0.29). CDS symptoms correlated significantly with learning difficulties (r = 0.65), inattention (r = 0.52), and hyperactivity/impulsivity (r = -0.37). In multiple regression analysis (epilepsy group, n = 200), CDS (β = 0.52), inattention (β = 0.42), hyperactivity/impulsivity (β = 0.11), and polytherapy (β = 0.09) independently predicted learning difficulties (R² = 0.89); epilepsy duration was not significant (p = 0.055).

CDS symptoms independently associated with learning difficulties in pediatric epilepsy beyond ADHD-related symptoms. Routine CDS screening should be considered in children with epilepsy presenting with academic concerns.