Abstracts

Rationale: Children with epilepsy are at greater than normal risk of experiencing cognitive deficits, attention problems, and learning difficulties. Current research concerning the nature and early course of cognitive functioning is limited. Existing studies suggest that some difficulties are present at the time of seizure onset and sometimes predate onset of seizures. No studies to date have examined the neuropsychological profiles and epilepsy variables with comprehensive evaluation and comparison of initial diagnosis and 1-year follow-up. Understanding these relationships is essential to early intervention and optimal epilepsy treatment. The current study examines neuropsychological profiles and seizure variables among children with epilepsy, 1-year following initial evaluation (T2), compared to findings at initial diagnosis (T1).Methods: 18 patients, recruited from NOPE clinic, underwent neuropsychological screening shortly after initial diagnosis and 1-year following initial evaluation. Mean age at T2 was 8.9 years (range: 4.1 - 14.6 years). 7 females. 8 primary generalized , 10 partial onset.Results: Of the 18 patients seen at T2, 6 showed significant decline in the domain of verbal/language functioning, and 14 showed significant decline in the domain of nonverbal/visuospatial functioning. 4 showed significant decline/lack of expected progress in at least 1 academic area. 5 showed significant decline in fine motor dexterity. Decline was defined as a difference of 10 or more standard score points. Since T1, 2 patients (11%) who initially evidenced risk factors for ADHD and/or LD met criteria for one of the diagnoses at T2. 4 patients (22%) who were previously identified as demonstrating risk factors for ADHD and/or LD continued to show risk at T2. 7 patients (39%) were identified as demonstrating new risk factors for ADHD and/or LD. IEP/504 was initiated for 3 participants since T1.Conclusions: The majority of patients demonstrated decline in one or more areas on neuropsychological testing one year following initial epilepsy diagnosis and evaluation. Previously identified risk factors for ADHD or LD evolved to formal diagnoses at follow up, and a large portion of patients evidenced new risk factors within one year of epilepsy diagnosis. These findings highlight the value of neuropsychological screening early in the course of epilepsy, even in the absence of overt/reported concerns. The increased incidence of cognitive comorbidities among children with epilepsy is apparent at onset, and there is measurable change within the first year after initial diagnosis.