Proposal for a Multicenter Study on Epilepsy and Learning Disorders in Children

Abstract

Learning disorders (LDs) in children with epilepsy are symptom complexes involving discrete functions (reading, mathematics, and writing), which are not included in the concept of mental retardation and cognitive dysfunction. LDs are frequently reported in patients with epilepsy, but the cause–effect relationship between the two conditions is far from defined. Patients with epilepsy are at risk of LDs for several reasons, including epilepsy per se, its pharmacologic and surgical treatment, the presence of an underlying epileptogenic condition with brain involvement, the emotional reactions to the disease, and association purely by chance (1). Learning and behavioral problems are more common in children with epilepsy than in the general population (2,3). In addition, children with known epileptogenic conditions have more LDs than do children with idiopathic or cryptogenic epilepsies (4). The treatment of epilepsy has a role in the occurrence of LDs, since most of the available compounds tend to interfere with brain activities by affecting vigilance and cognitive functions (5). Even though several reports suggest that epilepsy and its treatment may cause LDs, the independent role of the disease, of its causes and treatments, and their interactions remain ill defined. First, the prevalence of LDs tends to vary according to the population at risk, the criteria adopted for the diagnosis, and the intensity of case ascertainment. Second, the distribution of LDs in patients with idiopathic, cryptogenic, and symptomatic epilepsy is poorly defined. Third, the risk of LDs attributable to AEDs is as yet unknown.