The association of MRI findings and neuropsychological functioning after the first recognized seizure.
OBJECTIVE
To explore relationships between MRI abnormalities of the brain and neuropsychological functioning in children who were evaluated following their first recognized seizure.


METHODS
Subjects were children aged 6 to 14 years with a first recognized seizure within the past 3 months who participated in a larger prospective study of child adaptation. The 249 children with neuropsychological testing and neuroimaging were studied. Children underwent neuropsychological examination an average of 2.8 months and MRI examination an average of 1.3 months after the first recognized seizure. On factor analysis four factors were found for neuropsychological function: LANG = Language, PS = Processing Speed, EC = Executive/ Construction, VMEM = Verbal Memory and Learning. For analysis, structural abnormalities found on MRI were classified as significant (yes/no) based on whether they were presumed to be related to the seizure condition.


RESULTS
On MRI, 34 (14%) had structural abnormalities that were judged to be significant in that they were possibly related to their seizures. Children with significant abnormalities had significantly lower estimated IQ scores and significantly lower language, processing speed, executive/constructional ability, and verbal memory and learning factor scores than did children without significant abnormalities.


CONCLUSIONS
Children who have structural brain abnormalities at onset have slightly lower cognitive functioning overall, and all neuropsychological domains seemed to be affected relatively equally. This pattern was apparent even when we restricted the analysis to children with intellectual functioning in the broadly normal range.
Byars
Anna W
AW
Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
deGrauw
Ton J
TJ
Johnson
Cynthia S
CS
Fastenau
Philip S
PS
Perkins
Susan M
SM
Egelhoff
John C
JC
Kalnin
Andrew
A
Dunn
David W
DW
Austin
Joan K
JK
D000293:Adolescent; D001921:Brain / Q000473:pathology*; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D004827:Epilepsy / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007361:Intelligence Tests / Q000706:statistics & numerical data; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011446:Prospective Studies