title: Global cognitive function in children with epilepsy: a community-based study.
abstract: OBJECTIVE
  To determine the frequency and determinants of subnormal global cognitive function in a representative, community-based sample of children prospectively identified at the time of initial diagnosis of epilepsy.
  
  
  METHODS
  In children enrolled with newly diagnosed epilepsy and followed a median of 10.5 years, level of cognitive function (within normal, borderline, mild, moderate to severe mental retardation (MR), neurologically devastated, and impaired but not further classified (NFC)) was determined based upon neurologists' and school records, repeated parental interviews, and, in over half the participants, standardized neuropsychological testing. For multivariable analyses, subnormal cognitive function was designated as consistent with a full scale IQ < 80.
  
  
  RESULTS
  Global cognitive function was considered within normal, N = 451 (73.6%), borderline, N = 31 (5.1%), mild MR, N = 21 (3.4%), more severe MR, N = 45 (7.3%), devastated, N = 29 (4.7%), and impaired-NFC, N = 36 (5.9%). Age at onset <5 years, symptomatic etiology, epileptic encephalopathy, remission status and current AED treatment were each strongly associated with level of cognitive function (all p-values <0.0001). In a multivariable logistic regression model, all variables except remission status independently contributed to subnormal global cognitive function.
  
  
  CONCLUSIONS
  Evidence of subnormal global cognitive function is apparent in approximately one of four children with epilepsy. Young age at onset, symptomatic cause, epileptic encephalopathy, and continued treatment, despite their strong intercorrelations, are independently associated with this outcome.
authors: Department of Biology, Northern Illinois University, DeKalb, Illinois 60115, USA. atberg@niu.edu
authors: Anne T
authors: AT
authors: Berg
authors: John T
authors: JT
authors: Langfitt
authors: Francine M
authors: FM
authors: Testa
authors: Susan R
authors: SR
authors: Levy
authors: Francis
authors: F
authors: DiMario
authors: Michael
authors: M
authors: Westerveld
authors: Joseph
authors: J
authors: Kulas
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003071:Cognition / Q000145:classification; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D003237:Connecticut / Q000453:epidemiology; D003625:Data Collection; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000453:epidemiology; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology*; D004829:Epilepsy, Generalized / Q000175:diagnosis / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D013577:Syndrome; D014888:Wechsler Scales / Q000706:statistics & numerical data