Abstracts

The functional repercussion of epilepsy on cognition remains unclear. Whereas idiopathic and well control seizures have been associated with a favourable cognitive prognosis (Ellenberg et al, 1986, [italic]N Engl J Med[/italic], 314: 1085-1088); symptomatic epilepsy, uncontrolled seizures, multiple anticonvulsant use and early onset of epilepsy appear to be risk factors for a poor cognitive outcome (Vingerhoerts, 2006, [italic]Seizure[/italic], 15, 221-226). The goal of our pilot study was to investigate the neuropsychological profile of newly diagnosed school age children with idiopathic epilepsy., 13 school aged children between 6 and 12 years old with newly diagnosed epilepsy, were submitted to the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV) (2004) and the Vineland Adaptive Behavior Scales (1984) within two weeks of seizure onset. Six children were diagnosed with partial epilepsy, and 7 children with generalised epilepsy. Twelve children were taking one anticonvulsant and all had well-controlled seizures. All children were attending regular classes in an appropriate grade level., All children, but two (GIQ 77, 84), had Full Scale IQ (FSIQ), Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) and Processing Speed Index (PSI) within the average range (Figure 1). All children had adaptive behaviour scores within the average range (mean of 104,76, std deviation 10,9). An age factor was found on cognitive indexes of the WISC-IV. Indeed, analysis of variance shows significant age group effect on the FSIQ (F =15,595 p = 0,001) and WMI (F= 13,658 p= 0,001). In fact, children between 7.2 [ndash] 9 years of age showed lower FSIQ and WMI compared to children of 6-7 years old (FSIQ p=0,002; WMI p=0,002) and children of 10-12 years old (FSIQ p=0,002; WMI p=0,011). This effect did not correlate with seizure type or epilepsy syndrome diagnosis., Our pilot study suggests reduced cognitive functioning within newly diagnosed children of 7.2 - 9 years of age compared to 6-7 years old children and to 10-12 years old children. These results may indicate critical periods for the development of specific cognitive skills, which may be particularly vulnerable within newly diagnosed children of 7.2-9 years of age. For example, working memory has been found to improve more significantly starting at age 7 (Huizinga et al., 2006, [italic]Neuropsychologia[/italic], [italic]In Press online [/italic]) within the normal population. Further research needs to be conducted to confirm our preliminary results and to define the cognitive abilities, which may be sensitive to the onset of epilepsy within particular developmental periods so preventative measures can be proposed to the patients, their family and teachers., (Supported by Savoy Foundation, Montreal; Epilepsie Montreal Metropolitain.)