Abstracts

Epilepsy is associated with neuropsychological deficits in children with chronic epilepsy. The present study investigates differences between seizure types at the onset of the disorder.
Participants were 199 children who had just experienced their first recognized seizure (FRS). For primary seizure type, 55 children had Generalized Tonic/Clonic seizures (GTC); 28 Childhood Absence Epilepsy (CAE); 12 Elementary Partial (EP); 42 Complex Partial (CP); 18 Elementary Partial with Secondary Generalization (EPSG); and 44 Complex Partial with Secondary Generalization (CPSG). There were almost equal numbers of boys (50.3%) and girls (49.7%), and most (91%) were right-handed. Mean IQ was in the middle of the average range (M = 101.2, SD = 15.9). Mean age at first seizure was 9.6 years (SD = 2.5), and mean latency from FRS to neuropsychological evaluation was 82.3 days (SD = 42.8). Groups were compared on 24 neuropsychological variables measuring attention, processing speed, spatial skills, executive functioning, memory, and language using analysis of variance (ANOVA). When there was a significant effect for seizure type, Duncan[rsquo]s multiple range test was used to determine which groups significantly differed.
Children with CAE took longer to process simple decisions (CPT-II Response Time, p=.0002) than did children with either GTC, EP, or CPSG. In addition, children with CAE had more difficulty sustaining their attention (CPT-II %Omissions T score, p=.046) compared to children with EP, EPSG, or CPSG. Finally, children with CAE or CPS made more errors on a measure of executive functioning (WCST %Errors T score, p=.045) compared to children with EP.
A recent study found that children with absence epilepsy show neuropsychological deficits in parent-reported attention problems and on objective measures of complex motor timing/working memory, visual-motor planning/integration, and executive functioning (Conant, Wilfong, & Inglese, 2003). The present study provides additional support for those findings and suggests that these cognitive inefficiencies are evident very early in the disorder for children with absence seizures. However, this may reflect greater chronicity in the present study, inasmuch as these children often have unrecognized seizures long before diagnosis. In conclusion, although health care professionals commonly consider absence seizures [ldquo]benign,[rdquo] these children appear to be at increased risk for cognitive problems. Children with absence seizures, as well as those with complex partial seizures, should be monitored closely for cognitive complaints already at the onset of the disorder.
Conant L, Wilfong A, & Inglese C, Cognitive and behavioral functioning in childhood absence epilepsy. J Intl Neuropsychol Soc 2003;9:276.
[Supported by: NIH/NINDS #22416 (to JKA)]