Cognitive profile of patients with childhood onset focal epilepsy: a pilot study

Abstract

The timely detection of cognitive impairment in pediatric epilepsy is a pressing issue in neurological practice. This study examined cognitive changes in children aged 5 to 17 years (inclusive) with temporal lobe epilepsy (26 subjects) and self-limited epilepsy with centrotemporal spikes (22 subjects). The control group consisted of 32 healthy volunteers aged 6 to 17 years (inclusive). A comparative analysis of cognitive testing results using the Wechsler cognitive assessment (child and adult versions) revealed multiple changes in verbal and nonverbal functions in patients with epilepsy compared to the control group. Patients with self-limited epilepsy with centrotemporal spikes also showed more pronounced changes in verbal IQ, with scores decreasing relative to the group of patients with temporal lobe epilepsy and the control group. A correlation was also noted between a right-sided focus of epileptiform activity and statistically significantly lower scores on the nonverbal IQ subtests. Similarities in cognitive profile changes were also observed in patients with genetic and structural focal epilepsy. However, the diffuse changes revealed by the test results were consistent with normal IQ scores. The findings demonstrate the widespread influence of epileptogenic processes on the development of cognitive functions, as well as the high compensatory capacity of children. Thus, neuropsychological examination of children with epilepsy already at the early stages of the disease can reveal deviations in the development of cognitive status, which can significantly affect the further development and socialization of pediatric patients and necessitates the organization of neuropsychological screening for this pathology.