Cognitive function in idiopathic generalized epilepsy of childhood

Abstract

This study evaluated the cognitive profiles of children with idiopathic generalized epilepsy (IGE), uniformly treated with valproic acid with well-controlled seizures. Twenty-four were neuropsychologically evaluated. They comprised: 14 females, 10 males: 12 with generalized tonic-clonic seizures (GTCS), mean age 14y 4mo, SD ly 7mo, range 12y to 16y 4 mo; 12 with absence seizures (AS]) mean age 14y 5mo, SD ly 10mo, range 11y to 16y 4mo, with intellectual abilities within the normal range and age-appropriate scholastic skills, and 20 healthy controls (12 females, 8 males; mean age 14y 5mo, SD 1y 10mo, range 10y 7mo to 16y 7mo). As a group, children with IGE performed significantly poorer in all tests (non-verbal and verbal attention, verbal learning and memory, word fluency, and controlled sequential fine motor responses) excluding non-verbal memory. Analysis according to type of seizure revealed that both patient groups (AS and GTCS) had an attention deficit, whereas only children with AS showed deficits in verbal learning and memory, word fluency, and controlled fine motor responses. These results suggest a long-term risk of learning impairment for children with IGE, even if they have normal intelligence and their seizures are well controlled.

Insights into the Mechanisms of Absence Seizure Generation Provided by EEG with Functional MRI

“…Cognitive deficits may be more marked in children when seizures begin before 4 years of age (15). Furthermore, when comparing children with GGE, with and without AS, it was found that children with AS had more pronounced deficits in verbal performance measures when compared to those with convulsions and controls (16). In JME, it has been noted that there is impaired deactivation of the default mode network (DMN) and abnormal coupling of cognitive and motor systems, which is felt to explain the interaction between cognitive effort and myoclonus (19).…”

Memory Functioning in Children with Epilepsy: Frontal Lobe Epilepsy, Childhood Absence Epilepsy, and Benign Epilepsy with Centrotemporal Spikes

“…Memory deficits have been documented especially in children with temporal lobe epilepsy [1–7]. But several studies have shown that memory problems may be present in other epilepsy syndromes, such as frontal lobe epilepsy [7–12] and idiopathic generalized epilepsy including childhood absence epilepsy [7, 13, 14] and benign epilepsy with centrotemporal spikes [15–17]. …”

“…Although memory deficits are more often present in focal epilepsies, some studies have also found memory problems—especially in visual memory—in children with childhood absence epilepsy [10, 13, 14, 21], while others have not found significant differences in memory functioning in these epileptic syndromes [22, 23]. However these children are usually integrated in a miscellanea group that includes not only children with childhood absence epilepsy, but also juvenile absence seizures, juvenile myoclonic epilepsy, and grand mal seizures on awakening, integrating several generalized idiopathic epileptic syndromes.…”

Intellectual functioning in pediatric patients with epilepsy: a comparison of medically controlled, medically uncontrolled and surgically controlled children

“…Engelberts et al 7 investigaram anteriormente o desempenho cognitivo em pacientes com epilepsia crônica bem controlada e controles saudáveis e não observaram déficits na atenção seletiva, memória e funções executivas quando comparados os dois grupos. Seus achados contrastaram com um estudo realizado por Henkin et al 25 , no qual os autores mostraram que crianças com epilepsia bem controlada (2,3 crises por ano) tiveram um pior desempenho do que crianças saudáveis em todos os domínios cognitivos, apesar de seu QI normal.…”