P33 – 2709: Cognitive abilities of school children with epilepsy: Evaluation after AED treatment withdrawal

Abstract

Objective Children with epilepsy have elevated risk of cognitive and behavioural disorders. Difficulties in cognition, behaviour, educational underachievement associated with childhood epilepsy have also been identified in otherwise healthy children with normal intelligence and attend regular schools. Lasting educational and psychosocial deprivation had been reported in follow-up studies in adults with history of childhood epilepsy. Aim Evaluation of cognitive abilities of children with idiopathic epilepsy after AED treatment withdrawal. Methods Preliminary results of cognitive abilities in 39 children aged 9.6 to 15.8 years after discontinuation of AED monotherapy (15 had generalized and 24 had partial epilepsy) were presented. The average treatment duration was 3.5 years. Cognitive functions were evaluated 6 to 8 months after the AED treatment withdrawal using The Wechsler Intelligence Scale for Children-IV. Results of the 10 subtests were combined in 4 indices: Verbal Comprehension, Perceptual Reasoning, Working Memory and Processing Speed Index. Results were compared to normative values. Results The mean value of total IQ was average. Verbal comprehension and perceptual reasoning index mean values were inside the average range. The working memory indicators were in the low average level, suggesting weakness in this area. The greatest weakness was found in processing speed with index in the edge of low average and borderline range. Conclusion Our preliminary results indicate that after AED treatment withdrawal in children with epilepsy weaknesses were still present in processing speed and working memory. This could potentially represent an important form of residual cognitive difficulty. How long these comorbidities of epilepsy may persist, after the seizures have been completely resolved, is still questionable. Our analyses support the need to evaluate cognitive skills in children with epilepsy, not only prior to initiating, adding to or changing an AED regimen, but also in the follow-up after AED treatment withdrawal.