Cognitive and behavioural findings in children with frontal lobe epilepsy

Hilde M. H. Braakman*, Dominique M. Ijff, Maarten J. Vaessen, Mariette H. J. A. Debeij-van Hall, Paul A. M. Hofman, Walter H. Backes, Johan S. H. Vles, Albert P. Aldenkamp

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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. Aims: 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.
Original languageEnglish
Pages (from-to)707-715
JournalEuropean Journal of Paediatric Neurology
Volume16
Issue number6
DOIs
Publication statusPublished - Nov 2012

Keywords

  • Epilepsy
  • Frontal lobe
  • Cognition
  • Behaviour
  • Child

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