title: Cognitive and behavioural findings in children with frontal lobe epilepsy.
abstract: BACKGROUND
  Frontal Lobe Epilepsy (FLE) is the second most frequent type of partial epilepsy and its onset is generally in childhood. Though cognitive and behavioural impairments have been described as co-morbid disorders in epilepsy, their extent in FLE, particularly in children, remains unknown.
  
  
  OBJECTIVE
  In this study, we assess cognitive skills and behaviour in a cohort of paediatric FLE patients.
  
  
  METHODS
  We measured the performance of 71 children with cryptogenic FLE on intelligence tests, neuropsychological tests, and behavioural questionnaires. Age-dependent normative values were used for reference. Results were related to epilepsy-factors including age at epilepsy onset, duration of epilepsy, seizure frequency, localisation of the epileptic focus and drug load.
  
  
  RESULTS
  Paediatric FLE patients performed worse on intellectual and neuropsychological tests compared to reference values, and had a delay in school achievement. The performance of patients was typically worse on tasks measuring visual-spatial functions, memory, psychomotor speed and alertness. High seizure frequency was associated with lower scores on the arithmetic subtest of the intelligence scale; the other epilepsy-factors had no statistically significant influence on intelligence test or neuropsychological test outcome. Behavioural problems included attention problems, anxiety and internalising behaviour. These were not significantly related to epilepsy-factors.
  
  
  CONCLUSIONS
  Children with cryptogenic FLE show a broad range of cognitive and behavioural impairments, compared to reference values. While high seizure frequency may affect performance on selected cognitive measures, other epilepsy-factors do not seem to influence cognition and behaviour. Study of micro-structural or functional brain abnormalities that underlie these cognitive and behavioural impairments are warranted.
authors: Department of Neurology, Maastricht University Medical Centre, P. Debyelaan 25, 6202 AZ Maastricht, The Netherlands. hilde.braakman@gmail.com
authors: Hilde M H
authors: HM
authors: Braakman
authors: Dominique M
authors: DM
authors: Ijff
authors: Maarten J
authors: MJ
authors: Vaessen
authors: Mariette H J A
authors: MH
authors: Debeij-van Hall
authors: Paul A M
authors: PA
authors: Hofman
authors: Walter H
authors: WH
authors: Backes
authors: Johan S H
authors: JS
authors: Vles
authors: Albert P
authors: AP
authors: Aldenkamp
mesh_terms: D000293:Adolescent; D001288:Attention / Q000502:physiology; D002648:Child; D002652:Child Behavior; D003071:Cognition / Q000502:physiology*; D015331:Cohort Studies; D004522:Educational Status; D017034:Epilepsy, Frontal Lobe / Q000523:psychology*; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D057567:Memory, Long-Term / Q000502:physiology; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology; D013028:Space Perception / Q000502:physiology