Growing up with epilepsy: a two-year investigation of cognitive development in children with new onset epilepsy

Abstract

Purpose: To characterize patterns and determinants of normal and abnormal cognitive development in children with new onset epilepsy compared to healthy controls.

Methods: Longitudinal (2-year) cognitive growth was examined in 100 children, age 8-18 years, including healthy controls (n = 48) and children with new onset epilepsy (n = 52). Cognitive maturation was examined as a function of the presence/absence of two neurobehavioral comorbitiies (attention deficit hyperactivity disorder and/or academic problems) identified at the time of epilepsy diagnosis. Groups were compared across a comprehensive neuropsychological battery assessing intelligence, academic achievement, language, memory, executive function, and psychomotor speed.

Results: Children with new onset epilepsy without neurobehavioral comorbidities were comparable to healthy controls at baseline, rate of cognitive development, and follow-up assessment across all neuropsychological domains. In contrast, the presence of neurobehavioral comorbidities was associated with significantly worse baseline and prospective cognitive trajectories across all cognitive domains, especially executive functions.

Conclusion: The presence of neurobehavioral comorbidities at the time of epilepsy onset is a major marker of abnormal cognitive development both prior to and after the onset of epilepsy.

Figure 1

Raw Verbal IQ scores. The top (a) panel provides a traditional comparison of control versus epilepsy groups. The middle (b) panel presents the results of the main analyses where children categorized by comorbidity+/− are contrasted to controls. The bottom (c) panel presents the results with the epilepsy comorbidity+ group subdivided into the ADHD and AP groups.

Figure 2

Raw CPT omission errors. The top (a) panel shows a traditional comparison of control versus epilepsy groups. The middle (b) panel presents the results of the main analyses where children categorized by comorbidity+/− are contrasted to controls. The bottom (c) panel presents the results with the epilepsy comorbidity+ group subdivided into the ADHD and AP groups.