Abstracts

Chronic epilepsy in adults is often associated with widespread neuropsychological dysfunction. Whether this cognitive morbidity is due to adverse progressive effects of epilepsy and its treatment, the impact of initial etiological factors, or the combined effects of cause and consequence of epilepsy remains to be deteremined. We have reported that children with [italic]chronic[/italic] epilepsy also exhibit relatively widespread cognitive difficulties. By examining children shortly after diagnosis and following them over time, the etiology of cognitive morbidity may be better understood. Of an anticipated final sample of 75 children with new onset epilepsy and 75 controls, this preliminary report describes results from 24 children; 15 with epilepsy (localization-related = 8, primary generalized = 7) with an average duration of 12.4 months, and 9 age-matched controls (first degree cousins). Recruitment is ongoing from two major health care systems in Wisconsin. Average age of the sample is 13.2 years (range 8-18); average grade level is 7 (range 2-13), and mean age of diagnosis for the epilepsy sample is 11.6 years. Subjects were administered a comprehensive battery of tests assessing intelligence, academic achievement, language, memory, executive functions, and motor speed. Pair-wise comparisons indicated no statistically significant differences between the children with epilepsy and the controls across measures of cognition. All children performed within the average range of intelligence (controls= 108.6, epilepsy = 111.7) and performances were similarly average/high average across tests of expressive and receptive vocabulary, immediate and delayed verbal and visual memory, executive function, and motor dexterity. Examination of academic achievement scores revealed that 20% of the children with epilepsy versus 0% of the controls exhibited significant learning disability or delay. These preliminary findings indicate that children with new onset epilepsy perform comparably to healthy controls across measures of cognition. Examination of individual subject data demonstrates higher rates of academic underachievement in new onset epilepsy (20%) compared to controls (0%). Increasing accrual of new onset cases and controls will facilitate additional comparisons (e.g., between epilepsy syndromes) as well as increased statistical power to identify the clinical and cognitive correlates of academic underachievement. (Supported by NIH NS R01-44351, F32 MH649882, and MO1 RR03186 (GCRC).)