The Intelligence of Epileptic Children

Abstract

Although epilepsy was known to Hippocrates, there is a strange lack of precision in our knowledge , not only of its mtiology, but of the mental disturbances associate(1 with it. Carvers has suggested that anatomical, physiological, psychological and other factors may all contribute to the production of the epileptic syndrome. In what we know of the mentality of epileptics there is much that seems contradictory. On the one hand, it is a common belief that some of the nmost distinguished figures in history, as, for instance, Napoleon, Julius Caesar, Mahomet, and Byron, suffered from the 'falling sickness on the other, it is well-known that subnormal mentality is common among epileptics. It is true that the meagre information we have of these cases suggests that some of them do not answer to what is now commonly called epilepsy. Mahomet's symptoms, for example, were those of hystero-epilepsy, and Cameron 3 has suggested that Byron suffered from a mild form of spastic paraplegia; buit it is probable that some of them were genuine epileptics. AManiy writers have commented on the high frequency of mental abnormality among epileptics, and a few have measured it by means of intelligenee or other tests. Shanahan1°found that of those in Craig Colony, New York, only 10% were mentally normal or approximately so; 15% he thought had deteriorated from apparent normality, while 7500 were from the first defective. Lowenstein8 tested 16 cases with the Yerkes-Bridges intelligence tests and found only 6 subnormal; some were distinctly superior, and three showed the typical epileptic constitution, in that they were emotional, suspicious and irritable. Coo0kson5 in a study of 100 children between the ages of 6 months and 11 1 years founid a more or less marked mental deficiency in 26. He writes:-Where mental deficiency was present, it had been noticed as early as the fits; in two cases mental impairment was stated to be progressive: of the mentally defective cases eight were born precipitately, six had spastic diplegia, one was a mongol, one was regarded as a postencephalitic mental defective, and two were microcephalic.

Effect of Major Motor Seizure Frequency upon Cognitive‐Intellectual Functions in Adults

“…Several investigators have attempted to answer the question of possible intellectual deterioration as a function of recurrent seizures (Patterson and Fonner, 1928;Fetterman and Barnes, 1934;Sullivan and Gahagan, 1935;Tenny, 1955). Dawson and Conn (1929) Part 2 of the present study clearly demonstrates the compounding effect of age at onset, duration of the disorder, and seizure frequency with respect t o adequacy of psychological functions. Table 5 shows a severe and generalized impairment in the high risk group which consisted of patients with long seizure history, early age at onset, and high seizure frequency, or any combination of two of these descriptors.…”

Changes in Seizure Frequency and Test‐Retest Scores on the Wechsler Adult Intelligence Scale

“…Nevertheless, the results of these studies, as well as a few using noninstitutionalized patients, failed to support a strict intellectual deterioration hypothesis. While findings did indicate considerable variability in retest scores on standardized psychometric tests of intellectual functioning, instances of stability and performance increases occurred as often as did decreases (Dawson and Conn, 1929; Fetterman and Barnes, 1934; Sullivan and Gahagan, 1935; Tenny, 1955).…”

Epilepsy.

“…Contrary to what might be expected, there appears to be no significant correlation between frequency of attacks and subsequent mental progress. Children with frequent seizures do not decline mentally at a more rapid rate than do those having a few attacks (5). One significant point established by retest studies is the great individual variability.…”