Cognitive Impairment in Epileptic Preschool Children

The age of onset of a child's first seizure is a significant predictor of cognitive impairment.

According to a recent study, the age of onset of a child’s first seizure is a significant predictor of cognitive impairment, as they discovered that cognitive impairment is perceptible in epileptic preschool children.

In the U.S. alone, it is estimated that there are over 325,000 children younger than fifteen who are diagnosed with epilepsy, and 45,000 new cases are diagnosed each year.

Previous medical evidence suggests that the earlier a child’s first seizure occurs, the more significant the cognitive impairment may be; but while preceding studies and reports correspond with these findings in older children, this study assessed cognitive impairment in children three to six years old.

For this study, researchers examined the medical history and psychological evaluations of sixty-four preschool children suffering from active epilepsy. Children participating in the study group possessed a mean age of five with seizure onset between zero and seventy-five months. "Our study is the first to examine cognitive performance in preschool children with epilepsy," said lead researcher Kati Rantanen, a PhD candidate at the University of Tampere in Finland.

Cognitive function was determined through psychological evaluation, parental reports, and observations from daycare. Researchers wished to establish the degree and frequency of cognitive impairment and the epilepsy-related factors contributing to the impairment.

The researchers measured the intelligence quotient (IQ) to determine the children’s cognitive function. Children were classified as having typical IQ (IQ over seventy) or with mild (fifty to sixty-nine), moderate (thirty-five to forty-nine), or profound (less than thirty-four) intellectual disability.

In the preschool group, 50% of the children exhibited normal cognitive function, 22% showed mild cognitive impairment, and 28% demonstrated moderate to severe intellectual disability.

The study revealed that the prevalence of epilepsy was roughly three per 1,000 children, which is consistent with prior studies in Finland and other developed countries.

The team classified twenty-seven children with focal seizures, thirty-one with generalized seizures, and six with unclassified seizure types. 64% of the children were receiving monotherapy of an anti-epileptic drug for seizure control.

The researchers also discovered the degree of control over the children’s seizures: seizures were well-controlled in 37% of children, partially controlled in 16%, and poorly controlled in the remaining 47% of participants.

The study established that early onset epilepsy is a risk factor for cognitive impairment. The authors warned that lower IQ test scores in young children with epilepsy may be partly due to a developmental delay instead of a mental disability.

"Early intervention programs may help to improve cognitive and psychological outcomes in preschoolers with epilepsy," Rantanen stated. "Further prospective research is needed to explore the developmental course of children with epilepsy."

This study is published in the journal Epilepsia.