J Korean Med Sci.  2018 Jan;33(3):e17. 10.3346/jkms.2018.33.e17.

Cognitive Function and Neuropsychological Comorbidities in Children with Newly Diagnosed Idiopathic Epilepsy

• Lee SY
• Park JH
• Park SJ
• Kim Y
• Lee KY

• KMID: 2400043
• DOI: http://doi.org/10.3346/jkms.2018.33.e17

Abstract

BACKGROUND
In this study, we aimed to identify cognitive function and neuropsychological comorbidities in children with newly diagnosed idiopathic epilepsy.
METHODS
We retrospectively reviewed the records of 97 antiepileptic drug-naïve children (9.7 ± 2.9 years; 54 males and 43 females) with newly diagnosed idiopathic epilepsy, all of whom underwent a neuropsychological battery. The battery consisted of the Korean Wechsler Intelligence Scale, Attention Deficit Hyperactivity Disorder (ADHD) Rating Scale, ADHD Diagnostic System, Children's Depression Inventory, and State-Trait Anxiety Inventory for Children. We investigated association between scores of the neuropsychological battery and epilepsy classification, lateralization of interictal epileptiform discharges (IEDs) on electroencephalography (EEG), and variables related to seizures.
RESULTS
Thirteen patients (14.3%) had ADHD symptoms. Three patients (4.1%) had depressive symptoms, and 9 (12.3%) had anxiety symptoms. Patients with idiopathic generalized epilepsy (IGE) had significantly lower full-scale intelligence and performance intelligence quotient scores than patients with idiopathic localization-related epilepsy (ILRE) (89.0 ± 17.6 vs. 96.3 ± 14.8; P = 0.030 and 88.9 ± 16.3 vs. 97.0 ± 16.4; P = 0.016, respectively). Patients with ILRE having unilateral IEDs had significantly higher full-scale intelligence quotient scores than patients with ILRE having bilateral IEDs and patients with IGE (99.9 ± 12.2 vs. 93.7 ± 16.1 vs. 89.0 ± 17.6; P = 0.039, respectively).
CONCLUSION
Our results suggest that idiopathic epilepsy may be accompanied by various neuropsychological comorbidities even at initial diagnosis. Patients with IGE and ILRE having bilateral IEDs on EEG appear more likely to be at high risk of decreased cognitive function.

Keyword

Generalized Epilepsy; Partial Epilepsy; Child; Comorbidity; Neuropsychological Tests

MeSH Terms

Anxiety
Attention Deficit Disorder with Hyperactivity
Child*
Classification
Cognition*
Comorbidity*
Depression
Diagnosis
Electroencephalography
Epilepsies, Partial
Epilepsy*
Epilepsy, Generalized
Humans
Immunoglobulin E
Intelligence
Male
Neuropsychological Tests
Retrospective Studies
Seizures
Immunoglobulin E