title: Long-term neurocognitive outcome and auditory event-related potentials after complex febrile seizures in children.
abstract: OBJECTIVE
  Whether prolonged or complex febrile seizures (FS) produce long-term injury to the hippocampus is a critical question concerning the neurocognitive outcome of these seizures. Long-term event-related evoked potential (ERP) recording from the scalp is a noninvasive technique reflecting the sensory and cognitive processes associated with attention tasks. This study aimed to investigate the long-term outcome of neurocognitive and attention functions and evaluated auditory event-related potentials in children who have experienced complex FS in comparison with other types of FS.
  
  
  METHODS
  One hundred and forty-seven children aged more than 6 years who had experienced complex FS, simple single FS, simple recurrent FS, or afebrile seizures (AFS) after FS and age-matched healthy controls were enrolled. Patients were evaluated with Wechsler Intelligence Scale for Children (WISC; Chinese WISC-IV) scores, behavior test scores (Chinese version of Conners' continuous performance test, CPT II V.5), and behavior rating scales. Auditory ERPs were recorded in each patient.
  
  
  RESULTS
  Patients who had experienced complex FS exhibited significantly lower full-scale intelligence quotient (FSIQ), perceptual reasoning index, and working memory index scores than did the control group but did not show significant differences in CPT scores, behavior rating scales, or ERP latencies and amplitude compared with the other groups with FS. We found a significant decrease in the FSIQ and four indices of the WISC-IV, higher behavior rating scales, a trend of increased CPT II scores, and significantly delayed P300 latency and reduced P300 amplitude in the patients with AFS after FS.
  
  
  CONCLUSIONS
  We conclude that there is an effect on cognitive function in children who have experienced complex FS and patients who developed AFS after FS. The results indicated that the WISC-IV is more sensitive in detecting cognitive abnormality than ERP. Cognition impairment, including perceptual reasoning and working memory defects, was identified in patients with prolonged, multiple, or focal FS. These results may have implications for the pathogenesis of complex FS. Further comprehensive psychological evaluation and educational programs are suggested.
authors.affiliation: Department of Pediatrics, Cheng-Hsin General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: minlan456@hotmail.com.
authors.forename: Min-Lan
authors.initials: ML
authors.lastname: Tsai
authors.affiliation: Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan; School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
authors.forename: Kun-Long
authors.initials: KL
authors.lastname: Hung
authors.affiliation: Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Tsan
authors.affiliation: School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan; Department of Medical Research and Education, Cheng-Hsin General Hospital, Taipei, Taiwan.
authors.forename: William Tao-Hsin
authors.initials: WT
authors.lastname: Tung
mesh_terms: D000293:Adolescent; D001288:Attention / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D005071:Evoked Potentials; D005072:Evoked Potentials, Auditory; D005260:Female; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D012640:Seizures; D003294:Seizures, Febrile; D014888:Wechsler Scales
keywords: Cognitive function; Complex febrile seizures; Event-related potentials; Febrile seizures; IQ; P3 (P300)