Abstracts

Rationale: Cognitive deficits are common comorbidities in children with epilepsy, with impairments often present by the time of diagnosis. Neuropsychological screening should be considered when epilepsy is first diagnosed and repeated during a child s treatment and development. However, comprehensive neuropsychological testing is costly, time-consuming, and not available in all clinical settings. There are limited brief screening tools to evaluate cognitive function in children with epilepsy. We hypothesized that application of computerized cognitive testing methods would enable detection of changes in executive function after initiation of anti-epilepsy treatment.Methods: As part of an ongoing study, 18 children ages 8-17 with new-onset epilepsy were recruited prior to the initiation of medical therapy. All patients had normal neurological examinations and no MRI findings to account for seizures. Medication-naive participants completed a CNS Vital Signs (CNSVS) testing battery at the time of diagnosis and again at follow-up, 2-4 months after medication initiation. Participants performed the following tasks: verbal and nonverbal memory, finger tapping, symbol digit coding, Stroop, shifting attention, and the Continuous Performance Test. Parents also completed the Strength and Difficulties Questionnaire (SDQ) and at the follow up visit, the Hague Side Effects Scale (HASES), a checklist of common complaints of parents of children treated with anti-seizure medications. Results: Average age of participants was 13.16 (+ 2.12). Epilepsy subtypes were predominantly generalized onset (80%). The majority of patients had fewer than 5 lifetime seizures. Group global composite scores were comparable standardized age means. Follow up testing indicated significant positive effects of anti-epilepsy treatment for psychomotor speed (p < 0.01), reflected in improved performance in finger tapping and symbol digit coding. Parent reporting using the HASES or the SDQ did not corroborate with improvements in psychomotor speed and efficiency in completing the testing battery.Conclusions: Computerized cognitive testing in epilepsy patients is well tolerated and serial testing suggests the ability of detecting significant changes associated with introduction of anti-epilepsy treatment. Application of computerized methods may offer a time-efficient mechanism of quantifying changes associated with anti-epilepsy treatment.