Abstracts

Rationale: Cognitive abnormalities are an important potential comorbidity of childhood epilepsy, which are a major concern in public health. In a previous controlled prospective cohort study, we found that among children with new onset epilepsy, those with comorbid ADHD and/or Academic Problems (AP) exhibited a significantly abnormal trajectory with poorer cognitive performance, compared to those with no comorbidity and the healthy controls at baseline and 2 years later. The purpose of this study is to extend the previous longitudinal study and determine whether these trends of normal and abnormal cognitive trajectories remained 5 to 6 years after epilepsy onset.Methods: The sample consisted of 137 children between 8 and 18 years old with new onset idiopathic epilepsies (n = 75, mean = 12.52, SD = 3.23) and their healthy first-degree cousin controls (n = 62, mean = 12.99, SD = 3.03). All children underwent a neuropsychological evaluation at baseline, 2 years and 5 to 6 years following their initial evaluations. Standardized clinical and psychiatric assessment at baseline identified a group of children with epilepsy who presented with comorbid ADHD and/or AP (total n = 43). We used random effects modeling to characterize the longer term (5 - 6 years) outcomes of children with epilepsy with comorbid ADHD and/or AP compared to those with no comorbidity and the healthy controls.Results: The findings indicate that the prognostic significance of two specific neurobehavioral comorbidities, ADHD and AP, are associated with significant neuropsychological impairment (p < .05) across all cognitive domains at baseline testing, suggesting an antecedent neurobiological effect. Children with comorbid ADHD and/or AP show a significantly abnormal longitudinal trajectory (