The Effect of Early Versus Late Onset of Major Motor Epilepsy upon Cognitive‐Intellectual Performance

Dikmen, Sureyya; Matthews, Charles G.; Harley, John P.

doi:10.1111/j.1528-1157.1975.tb04723.x

Cited by 138 publications

(47 citation statements)

References 8 publications

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“…A high association between early onset by the Jennifer Wieser Fund, of seizures and mental defect has been reported in several previous studies [44][45][46][47]. These findings appear to support the notion that the early onset of seizures leads to mental defect; however, mental retardation in this group of children may also be due to the presence of more severe disturbances in brain function than in children with later seizure onset.…”

Section: Discussionsupporting

confidence: 74%

A follow‐up study of intractable seizures in childhood

Huttenlocher

Hapke

1990

Annals of Neurology

181

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One hundred forty-five children with seizures that were refractory to medical therapy for at least 2 years were followed 5 to 20 years after onset. The majority of children with uncontrollable seizures (61%) were mentally retarded, and most of these (73%) had onset of seizures at younger than 2 years of age. Age of onset was significantly later (mean 5.0 +/- 0.5 yr [SEM]) in the group of children with borderline to normal intelligence. Follow-up data showed remission of seizures in a significant proportion of children with borderline or normal intelligence, with a linear decrease of the percentage with persistent seizures at a rate of about 4% per year. Remission of seizures was much less frequent (1.5%/yr) in the group with mental retardation. Seizure type had some effects on outcome. Children with focal atrophic brain lesions did no worse than those without definable pathology on brain-imaging studies.

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Section: Discussionsupporting

confidence: 74%

A follow‐up study of intractable seizures in childhood

Huttenlocher

Hapke

1990

Annals of Neurology

181

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“…A wrinkle in this literature, alluded to in the Introduction, is that earlier age of seizure onset has been associated with poorer neuropsychological test performance (irrespective of surgical status), compared to later onset seizure disorder (e.g., Dikmen et al, 1975Dikmen et al, , 1977Hermann et al, 2002;Lespinet et al, 2002), which opens the possibility that early onset patients have relatively "less to lose" than late onset patients. It was possible to examine this possibility in some detail in our dataset.…”

Section: Discussionmentioning

confidence: 99%

“…Early-onset seizure patients have been consistently shown to perform more poorly on a wide range of neuropsychological measures as adults, when compared with late-onset patients, and the observed deficits appear to be more generalized and pervasive than would be expected based on what is known about the extent of structural lesion in these patients (Dikmen, Matthews & Harley, 1975;Dikmen, Matthews & Harley, 1977;Hermann et al, 2002;Lespinet, Bresson, N'Kaoua, Rougier & Claverie 2002). O'Leary, Seidenberg, Berent, and Boll (1981) found this age of onset effect even in young children and when controlling for potentially confounding variables such as seizure frequency.…”

Section: Functional Reorganizationmentioning

confidence: 93%

Age of seizure onset, functional reorganization, and neuropsychological outcome in temporal lobectomy

Griffin

Tranel

2007

Journal of Clinical and Experimental Neuropsychology

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Patients with early onset seizure disorder tend to have less cognitive decline following surgical resection than patients with late onset seizure disorder. Differential opportunity for presurgical cerebral functional reorganization has been proposed to account for this "age of onset" effect. However, the relationships between age of seizure onset, functional organization, and neuropsychological outcome remain incompletely understood. To shed additional light on these issues, we investigated 66 patients with anterior temporal lobectomies (37 left; 29 right), all of whom completed comprehensive neuropsychological assessment prior to and following surgical resection. The sample was divided into two groups: 34 patients with early onset (EO) epilepsy and 32 patients with late onset (LO) epilepsy. We found the typical age of onset effect: post-surgically, EO patients demonstrated relatively better outcome in multiple neuropsychological domains, especially verbal memory, compared to LO patients. Based on presurgical Wada testing, 23 patients were classified as having traditional cerebral functional organization (TFO) and 35 were classified as having nontraditional cerebral functional organization (NTFO). The NTFO group had an earlier age of seizure onset than the TFO group, and NTFO was more frequent in EO patients (70%) than LO patients (50%). NTFO patients demonstrated relatively better post-surgical outcome in several neuropsychological domains, compared to TFO patients. Our findings are consistent with the notion that functional reorganization may be an explanatory factor for the better neuropsychological outcome of EO epilepsy patients following anterior temporal lobectomy.

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“…These variables include the age of seizure onset (Dikmen, Matthews, & Harley, 1975Hermann et al, 2002;Lespinet, Bresson, N'Kaoua, Rougier, & Claverie, 2002;O'Leary, Seidenberg, Berent, & Boll, 1981), duration of illness (Jokeit & Ebner, 1999;Oyegbile et al, 2004), seizure frequency (McDonald, Delis, Norman, Wetter, Tecoma, & Iragui, 2005c;Thompson & Duncan, 2005), number of anticonvulsant medications (G. K. Motamedi & Meador, 2004), and the presence or type of structural pathology (McDonald, Delis, Norman, Tecoma, & Iragui, 2005a;York et al, 2003). For example, patients with TLE who have an early age of seizure onset have been found to show more pervasive cognitive impairments in general than those with a late seizure onset (Hermann et al, 2002;Lespinet et al, 2002), even after controlling for the duration of illness and seizure frequency .…”

Section: Introductionmentioning

confidence: 99%

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

McDonald

Delis

Kramer

et al. 2008

The Clinical Neuropsychologist

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The ability to interpret nonliteral, metaphoric language was explored in patients with frontal lobe epilepsy (FLE) and temporal lobe epilepsy (TLE), and matched control participants, to determine (1) if patients with FLE were impaired in their interpretations relative to those with TLE and controls, and (2) if disease-related variables (e.g., age of seizure onset) predicted performances in either patient group. A total of 22 patients with FLE, 20 patients with TLE, and 23 controls were administered a test of proverb interpretation to assess their ability to grasp the abstract meaning of nonliteral language. Participants were presented with a series of proverbs and asked to provide an oral interpretation of each. Responses to each proverb were scored according to their accuracy and level of abstractness. Patients with FLE, but not TLE, were impaired relative to controls in their overall interpretation of proverbs. However, a subgroup analysis revealed that only patients with left FLE showed impaired interpretation accuracy relative to the other groups, whereas patients with both left FLE and left TLE showed impaired abstraction. Patients with FLE were also impaired when they were asked to select the best interpretation of the proverb from response alternatives. In patients with FLE, only a left-sided seizure focus was associated with poorer performance. In patients with TLE, both an early age of onset and a left-sided seizure focus predicted poorer performance. Overall, FLE patients exhibit greater impairment than TLE patients in interpreting proverbs. However, the nature and disease-specific correlates of impaired performances in proverb interpretation differ between the groups.

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The Effect of Early Versus Late Onset of Major Motor Epilepsy upon Cognitive‐Intellectual Performance

Cited by 138 publications

References 8 publications

A follow‐up study of intractable seizures in childhood

A follow‐up study of intractable seizures in childhood

Age of seizure onset, functional reorganization, and neuropsychological outcome in temporal lobectomy

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

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