Neuropsychological and behavioural aspects in children and adolescents with idiopathic epilepsy at diagnosis and after 12 months of treatment.
OBJECTIVE
To study neuropsychological functions in children with idiopathic epilepsy at onset of treatment and after 1 year of therapy and to identify factors associated with cognitive impairment.


METHODS
43 Subjects aged 5.2-16.9 years with newly diagnosed idiopathic epilepsy were enrolled and started treatment with valproate or carbamazepine. At admission and after 12 months, all patients underwent clinical examinations, the Child Behavioural Checklist, EEG and a neuropsychological test battery. The results of each test were correlated to demographic, clinical, electrophysiological and therapeutic variables.


RESULTS
Except for attention, all neuropsychological functions were normal at admission and after 12 months. An improvement with time was noted for memory (p<0.05) and logical-executive functions (p<0.01). Attentive deficit was worse at 12 months (53.5% vs. 32.6%). Low socio-economic level and emotional and behavioural disturbances were the only factors negatively correlated to intelligence, memory and attention. Compared to valproate, carbamazepine was most commonly implicated.


CONCLUSIONS
Idiopathic epilepsy can affect attention, even before starting treatment. Emotional and behavioural difficulties and a low socio-economical status are associated with cognitive impairment.
Piccinelli
Paolo
P
Child Neuropsychiatry Unit, University of Insubria, Macchi Foundation Hospital, Varese, Italy.
Beghi
Ettore
E
Borgatti
Renato
R
Ferri
Matteo
M
Giordano
Laura
L
Romeo
Antonino
A
Termine
Cristiano
C
Viri
Maurizio
M
Zucca
Claudio
C
Balottin
Umberto
U
D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D001288:Attention / Q000502:physiology; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000139:chemically induced / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D004569:Electroencephalography; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D007360:Intelligence / Q000502:physiology; D016015:Logistic Models; D008297:Male; D008568:Memory / Q000502:physiology; D020190:Myoclonic Epilepsy, Juvenile / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology*; D009483:Neuropsychological Tests; D012959:Socioeconomic Factors; D013997:Time Factors; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use
D000927:Anticonvulsants; D002220:Carbamazepine; D014635:Valproic Acid