Abstract

Patients with epilepsy are at risk for several lifetime problems, in which neuropsychological impairments may represent an impacting factor. We evaluated the neuropsychological functions in children suffering from three main epilepsy categories. Further, we analyzed the longitudinal evolution of the neuropsychological profile over time. Patients undergoing neuropsychological evaluation at our Department from 2012 to 2018 were identified retrospectively. We selected patients aged 6-16 years and with at least two evaluations. Three epilepsy categories were considered: focal/structural, focal self-limited, and idiopathic generalized. Each evaluation included the same structured assessment of main neuropsychological domains. The effect of the epilepsy category, illness duration, seizure status, and medication was computed in multilevel models. We identified 103 patients (focal self-limited = 27; focal/structural = 51; and idiopathic generalized = 25), for 233 evaluations. The majority of deficits were reported in attention and executive functions (>30% of patients); the results were dichotomized to obtain global indexes. Multilevel models showed a trend toward statistical significance of category of epilepsy on the global executive index and of illness duration on global attention index. Illness duration predicted the scores of executive and attention tasks, while category and medication predicted executive task performance. Focal/structural epilepsies mostly affected the executive domain, with deficits persisting over time. By contrast, an ameliorative effect of illness duration for attention was documented in all epilepsies. This study offers lacking information about the evolution of deficits in time, the role of epilepsy category, and possible psychological implications for high-order cognitive skills, central in several social and academic problems.

Highlights

  • Patients with epilepsy are at risk for several problems, which can affect their life quality and social competences more than the seizures themselves.Among these issues, cognitive and neuropsychological impairments represent a very impacting factor, in those patients who show structural etiology (Rudzinski & Meador, 2013; Witt & Helmstaedter, 2012)

  • With the aim to provide an overview of neuropsychological impairments in childhood epilepsies, with a particular focus on attention and executive functions, we evaluated the performances of children suffering from the three main categories of epilepsy, such as focal/structural epilepsies, focal self-limited epilepsies, and generalized epilepsies

  • According to the above-mentioned eligibility criteria, we identified 103 patients and 233 neuropsychological evaluations

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Summary

Introduction

Patients with epilepsy are at risk for several problems, which can affect their life quality and social competences more than the seizures themselves. Among these issues, cognitive and neuropsychological impairments represent a very impacting factor, in those patients who show structural etiology (Rudzinski & Meador, 2013; Witt & Helmstaedter, 2012). The reported incidence of cognitive dysfunctions in children with focal cortical dysplasia ranges from 50% to 80% (Korman et al, 2013; Krsek et al, 2008). The most severe condition is represented by the developmental and epileptic encephalopathies with neonatal to childhood-onset that are associated with drug-resistant epilepsy and significant cognitive impairment

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