Baseline cognition, behavior, and motor skills in children with new-onset, idiopathic epilepsy

Aim  Epilepsy is associated with difficulties in cognition and behavior in children. These problems have been attributed to genetics, ongoing seizures, psychosocial issues, underlying abnormality of the brain, and/or antiepileptic drugs. In a previous study, we found baseline cognitive differences between children with partial versus generalized and convulsive versus non-convulsive seizures. Measures in that study focused primarily on IQ scores. In the present study, we assessed baseline function with respect to new learning, attention, and memory, thus providing a more comprehensive profile than our previous study.
Method  We examined 57 children (42 females, 15 males), aged 6 to 17 years (mean 10y 1mo, SD 2y 9mo), with new-onset, idiopathic epilepsy, using tests of cognitive function reflective of new learning, memory, and attention. Seizures were classified as generalized convulsive ( n =5), generalized non-convulsive ( n =18), or focal ( n =34). Focal seizures were divided into unilateral versus bilateral independent foci, and presence versus absence of secondary generalization.
Results  Attention was a particular area of weakness across all groups. The Vocabulary score of an intelligence screen was higher for the focal seizure groups ( p =0.012), primarily because of a difference between the unilateral focal and the primary generalized groups ( p <0.047). Children with generalized, non-convulsive seizures performed significantly worse than the focal group on a measure of short-term auditory memory ( p =0.019). All groups performed poorly on a test of visual–motor speed.
Interpretation  These findings suggest intrinsic abnormalities in children with new-onset, idiopathic epilepsy at baseline.