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Journal of Child Neurology
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Relative Influence of Epileptic Seizures and of Epilepsy Syndrome on Cognitive Function

Selma C. Tromp, MD, PhD

Department of Neurology University Hospital of Maastricht, The Netherlands

Jacobina W. Weber, MD

Department of Neurology University Hospital of Maastricht, The Netherlands, Department of Neurology Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands

Albert P. Aldenkamp, PhD

Department of Neurology University Hospital of Maastricht, The Netherlands aldenkampB{at}kempenhaeghe.nl., Department of Behavioural Sciences Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands, Faculty of Social and Behavioural Sciences University of Amsterdam, The Netherlands

Johan Arends, MD, PhD

Department of Neurology Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands, Department of Clinical Neurophysiology Epilepsy Centre, Kempenhaeghe, Heeze, The Netherlands

Inge vander Linden, MA

Department of Clinical Neurophysiology Epilepsy Centre, Kempenhaeghe, Heeze, The Netherlands

Leonie Diepman, MA

Department of Behavioural Sciences Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands

Cognitive impairment is frequently observed in children with epilepsy. We aimed at addressing to what extent cognitive function is affected by paroxysmal epileptiform activity with or without clinical seizures or by clinical features characteristic of the epilepsy syndrome. To this purpose, combined electroencephalographic (EEG) recording and cognitive testing (IQ and reaction times) were performed in 28 children. Frequent epileptiform EEG discharges significantly reduced reaction time, as did the occurrence of seizures during cognitive testing. Syndrome-related factors tended to affect cognitive functions as well: children with generalized epilepsy and high average seizure frequency obtained lower scores. Linear regression analysis showed that stable aspects of cognitive function, as reflected in intelligence level, are most closely related to the severity of the epilepsy syndrome (average seizure frequency), whereas transient aspects of cognitive function, such as reaction times, are related to the occurrence of epileptiform EEG discharges. This suggests that seizures have a direct effect on transient cognitive aspects, which can accumulate and result in effects on intelligence level. (J Child Neurol 2003;18:407—412).

Journal of Child Neurology, Vol. 18, No. 6, 407-412 (2003)
DOI: 10.1177/08830738030180060501


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