Abstracts

Rationale: Benign Rolandic Epilepsy (BRE) is a common pediatric epilepsy syndrome. It is now known that that this population is vulnerable to various cognitive problems despite preserved intelligence. We evaluated neurocognitive functioning in children with BRE to determine rates at which functioning fell within the at-risk/clinical range ("Problem Range," PR). We predicted that children with BRE would have greater neurocognitive dysfunction than expected relative to peers. Methods: Thirty-seven children ages 6-11 (mean=8.97; 62% male) with neurological history of BRE were recruited from clinical databases. Fourteen (38%) took antiepileptic drugs (AEDs); 16 (43%) had ≥1 parent with a graduate degree; and 10 (37%) had an Individualized Education Plan (IEP). Participants with seizures (34) had ~ 1 per month. Neurocognitive assessment included parent questionnaires and child testing. Results: Mean IQ (108.03; SD=15.57) was higher than the population mean, perhaps reflecting demographic factors. Though group means on all tests/questionnaires were within the average range, there was an elevated frequency of PR scores (>1.5 SD below normative mean) in specific domains. More than 15% of the sample—over twice the expected prevalence of 6.7%—scored within the PR for 28% of items, highlighting executive function, processing speed, academic achievement, and memory concerns. Problems tended to be clustered in a subset of 10 individuals. AED treatment was not associated significantly with performance. Conclusions: Although neurocognitive functioning was on average within normal limits, a subset of this sample displayed elevated cognitive vulnerability, manifest in assessment results and in provision of an IEP. These cognitive problems are not related to medication effects alone, but are potentially related to epileptiform abnormalities. Further investigation will establish the extent to which these outcomes may be related to epileptiform abnormalities that alter brain function. This research was supportated by pilot brant funding from Boston Children's Hospital Clinical Research Program.