The neuropsychological and language profile of children with benign rolandic epilepsy.
OBJECTIVE
Benign rolandic epilepsy (BRE) has an excellent prognosis for seizures, but recent research has raised concerns using cognition as an outcome measure. Methodologic problems related to recruitment bias and assessment processes are evident in previous studies. With well-defined criteria for inclusion and comprehensive assessment, the aim of this study was to define the cognitive profile of children with BRE and to assess the effect of interictal EEG activity.


METHODS
Patients (n=42) were recruited from six EEG laboratories. The EEG features analyzed were spike frequency, trains, and laterality. Comprehensive neuropsychological and language assessments were conducted. Group means on cognitive measures were compared with normative means. Tests were correlated with EEG features.


RESULTS
The study demonstrated that children with BRE have normal intelligence and language ability. However, a specific pattern of difficulties in memory and phonologic awareness was found. Furthermore, a large proportion of children had disproportionate scores in these areas compared with intellectual and language ability. EEG features were minimally associated with cognitive difficulties, and no correlation was found with memory indices and tests of phonologic awareness.


CONCLUSIONS
Some children with BRE have specific difficulties in memory and phonologic processing skills, not explained by interictal activity. We recommend that pediatricians ask about academic performance specifically in areas of prereading, reading, spelling, and memory. If difficulties are suspected, assessment targeting phonologic awareness and memory are recommended, as they may not be reflected in overall intellectual and language ability. Difficulties in phonologic awareness affect literacy, and memory problems affect academic performance.
Northcott
Ellen
E
School of Women's and Children's Health, University of NSW, Australia.
Connolly
Anne M
AM
Berroya
Anna
A
Sabaz
Mark
M
McIntyre
Jenny
J
Christie
Jane
J
Taylor
Alan
A
Batchelor
Jennifer
J
Bleasel
Andrew F
AF
Lawson
John A
JA
Bye
Ann M E
AM
D000124:Achievement; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D004569:Electroencephalography / Q000706:statistics & numerical data; D019305:Epilepsy, Rolandic / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D007804:Language Development; D007807:Language Tests; D008297:Male; D009483:Neuropsychological Tests; D011379:Prognosis