Attention and executive functions in the early course of pediatric epilepsy

Gitta Reuner; Navah Esther Kadish; Jan Henje Doering; Doreen Balke; Susanne Schubert-Bast

doi:10.1016/j.yebeh.2016.04.011

Attention and executive functions in the early course of pediatric epilepsy

Epilepsy Behav. 2016 Jul:60:42-49. doi: 10.1016/j.yebeh.2016.04.011. Epub 2016 May 11.

Authors

Gitta Reuner¹, Navah Esther Kadish², Jan Henje Doering³, Doreen Balke³, Susanne Schubert-Bast⁴

Affiliations

¹ University Children's Hospital Heidelberg, Section Neuropediatrics and Inborn Errors of Metabolism, Heidelberg, Germany. Electronic address: gitta.reuner@med.uni-heidelberg.de.
² University Children's Hospital Heidelberg, Section Neuropediatrics and Inborn Errors of Metabolism, Heidelberg, Germany; Department of Neuropediatrics, University Medical Center Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany; Department of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany.
³ University Children's Hospital Heidelberg, Section Neuropediatrics and Inborn Errors of Metabolism, Heidelberg, Germany.
⁴ University Children's Hospital Heidelberg, Section Neuropediatrics and Inborn Errors of Metabolism, Heidelberg, Germany; Department of Pediatric Neurology, Goethe University Hospital, Frankfurt, Germany.

PMID: 27179191
DOI: 10.1016/j.yebeh.2016.04.011

Abstract

Objective: Our prospective study aimed at exploring attention and executive functions in children with new-onset epilepsy prior to and during the early course of antiepileptic treatment. Sociodemographic and epilepsy-related factors were analyzed as potential predictors both of impaired cognitive functions as well as for changes in cognitive functioning in the early course of illness.

Methods: From a total group of 115 children aged six to 17years without major disabilities, 76 children were assessed longitudinally with a screening tool for attention and executive functions (EpiTrack Junior®). Sociodemographic variables (gender, age at epilepsy onset, need of special education) and epilepsy-related variables (etiology of epilepsy, semiology of seizures, number of seizures) were considered as potential predictors for impaired functions prior to treatment and for deterioration/amelioration in cognitive functions in the early course.

Results: Attention and executive functions of children with new-onset epilepsy were significantly more often impaired when compared with a healthy population, but less often when compared with children with chronic epilepsy. The majority of children showed stable cognitive functioning in the early course of treatment. The risk of impaired cognitive functions was significantly heightened when etiology of epilepsy was unknown or not classifiable. The chance for improvement of functioning was lowered by having a genetic epilepsy, or an unknown semiology of seizures.

Conclusions: Children with new-onset epilepsy are at high risk for impaired attention and executive functions even prior to antiepileptic treatment, especially when etiology of their epilepsy remains unclear. The high stability of cognitive functioning in the early course can be used in counseling of families who worry about negative side effects of drug treatment. Finally, a systematic assessment of cognitive functions in children with new-onset epilepsy is necessary to detect subtle deficits in the early course and adjust treatment accordingly.

Keywords: Antiepileptic drug treatment; Attention and executive functions; Childhood epilepsy; Cognition; New-onset epilepsy.

MeSH terms

Adolescent
Age of Onset
Anticonvulsants / therapeutic use
Attention*
Child
Chronic Disease
Cognition
Cognition Disorders / etiology
Cognition Disorders / psychology
Epilepsy / complications
Epilepsy / drug therapy
Epilepsy / psychology*
Executive Function*
Female
Humans
Longitudinal Studies
Male
Neuropsychological Tests
Prospective Studies
Psychomotor Performance

Substances

Anticonvulsants