title: Neuropsychological profiles and outcomes in children with new onset frontal lobe epilepsy.
abstract: Frontal lobe epilepsy (FLE) is the second most frequent type of localization-related epilepsy, and it may impact neurocognitive functioning with high variability. The prevalence of neurocognitive impairment in affected children remains poorly defined. This report outlines the neuropsychological profiles and outcomes in children with new onset FLE, and the impact of epilepsy-related factors, such as seizure frequency and antiepileptic drug (AED) load, on the neurocognitive development. Twenty-three consecutive children (15 males and 8 females) with newly diagnosed cryptogenic FLE were enrolled; median age at epilepsy onset was 7 years (6-9.6 years). They underwent clinical and laboratory evaluation and neuropsychological assessment before starting AED treatment (time 0) and after one year of treatment (time 1). Twenty age-matched patients affected by idiopathic generalized epilepsy (10 male and 10 females) and eighteen age-matched healthy subjects (9 males and 9 females) were enrolled as controls and underwent the same assessment. All patients with FLE showed a significant difference in almost all assessed cognitive domains compared with controls, mainly in frontal functions and memory. At time 1, patients were divided into two groups according to epilepsy-related factors: group 1 (9 patients) with persisting seizures despite AED polytherapy, and group 2 (14 patients) with good seizure control in monotherapy. A significant difference was highlighted in almost all subtests in group 1 compared with group 2, both at time 0 and at time 1. In children with FLE showing a broad range of neurocognitive impairments, the epilepsy-related factors mostly related to a worse neurocognitive outcome are poor seizure control and the use of AED polytherapy, suggesting that epileptic discharges may have a negative impact on the functioning of the involved cerebral regions.
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Matricardi
authors.affiliation: Clinical Epileptology and Experimental Neurophysiology Unit, Foundation I.R.C.C.S. Neurological Institute C. Besta, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Deleo
authors.affiliation: Department of Pediatric Neuroscience, Foundation I.R.C.C.S. Neurological Institute C. Besta, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Ragona
authors.affiliation: Department of Pediatrics, University of Perugia, Perugia, Italy.
authors.forename: Victoria Elisa
authors.initials: VE
authors.lastname: Rinaldi
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.
authors.forename: Sarah
authors.initials: S
authors.lastname: Pelliccia
authors.affiliation: Child and Adolescent Neuropsychiatry, Medical School, University of Salerno, Salerno, Italy.
authors.forename: Giangennaro
authors.initials: G
authors.lastname: Coppola
authors.affiliation: Department of Pediatrics, University of L'Aquila, L'Aquila, Italy. Electronic address: averrott@unich.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Verrotti
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000639:trends; D017034:Epilepsy, Frontal Lobe / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: Cognition; Epilepsy; Frontal lobe epilepsy; Neuropsychology; Pediatrics