Age at Onset and Neuropsychological Function in Frontal Lobe Epilepsy

Abstract

Summary:Purpose: Previous studies into the cognitive consequences of frontal lobe epileptic dysfunction may have proved inconclusive, due to a factor not commonly accounted for: Damage or disturbance during different epochs of development may give rise to different levels of neuropsychological dysfunction. In this study, we investigated the influence of age at onset on cognitive performance in a group of subjects with frontal lobe epilepsy (FLE).Methods: Seventy-four subjects (42 with left, and 32 with right) FLE were classified into early (0-6 years), intermediate (7-1 1 years) or late onset (212 years) and their performance recorded on a battery of measures assessing both executive and motor skills.Results: On the measures of executive functioning, no consistent pattern emerged, whereas on the measures of motor skill, the results suggested that a right-sided early onset (i.e., 0-6 years) did not impair performance compared to a later lesion within the same hemisphere. Furthermore, this sparing of performance was not observed within the left hemisphere.Conclusions: Overall, the results suggest that individuals with differing ages of epilepsy onset will be differentially impaired on certain cognitive tasks. Several tentative ramifications of these results are suggested.

A Componential Analysis of Proverb Interpretation in Patients with Frontal Lobe Epilepsy and Temporal Lobe Epilepsy: Relationships with Disease-Related Factors

“…The lack of a relationship between age of seizure onset and performances in the FLE group is not surprising given that few studies have found an association between seizure-related variables and degree of executive dysfunction in patients with FLE at the group level (McDonald, Delis, Norman, Tecoma, & Iragui, 2005b;Upton & Thompson, 1997). This lack of a relationship has been attributed to the fact that the complex, multi-stage maturation of the frontal lobes may obscure group differences when the location of frontal foci and ages of seizure onset are very heterogeneous in nature (Thatcher, 1991;Upton & Thompson, 1997).…”

“…This lack of a relationship has been attributed to the fact that the complex, multi-stage maturation of the frontal lobes may obscure group differences when the location of frontal foci and ages of seizure onset are very heterogeneous in nature (Thatcher, 1991;Upton & Thompson, 1997). For example, Upton and Thompson found that an early age of seizure onset predicted motor, but not cognitive, performances in patients with right, but not left, FLE.…”

Developmental stage affects cognition in children with recently-diagnosed symptomatic focal epilepsy

“…Upton and Thompson [36] stratified their sample of adults with frontal lobe epilepsy (FLE) according to three groups with different ages at seizure onset that correspond to stages of executive development. The two measures of executive function employed yielded inconsistent results but did not suggest a lasting effect of age at seizure onset.…”

Attention and Executive Functions in Children With Epilepsy: What, Why, and What to Do

“…Of course, frontal-lobe epilepsy has been associated with such deficits; these children often show problems with planning, impulse control, temporal orientation, sequencing, categorization, mental flexibility, and verbal reasoning (Auclair, Jambaque, Dulac, LaBerge, Upton & Thompson, 1997). However, even children with focal seizures that do not originate in the frontal regions can show attention and executive dysfunction.…”