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First Epileptic Seizure Linked to Cognitive Deficits

Last Updated: August 13, 2009.

Intellectually normal children with a first recognized epileptic seizure are significantly more likely than their healthy siblings to exhibit neuropsychological deficits, which suggests there is a window of opportunity for treatment that could reduce subsequent effects on academic performance, according to a study published online Aug. 12 in Neurology.

THURSDAY, Aug. 13 (HealthDay News) -- Intellectually normal children with a first recognized epileptic seizure are significantly more likely than their healthy siblings to exhibit neuropsychological deficits, which suggests there is a window of opportunity for treatment that could reduce subsequent effects on academic performance, according to a study published online Aug. 12 in Neurology.

Philip S. Fastenau, Ph.D., of University Hospitals Case Medical Center in Cleveland, and colleagues compared neuropsychological and academic achievement test scores in 282 children ages 6 to 14 with a first recognized seizure with those of 147 healthy siblings.

The researchers identified neuropsychological deficits in 27 percent of children with only one recognized seizure and in as many as 40 percent of those with associated risk factors, which included multiple seizures, use of antiepileptic drugs, symptomatic/cryptogenic etiology, and epileptiform activity on the initial electroencephalography (odds ratios, 1.96. 2.27, 2.15, and 1.90, respectively). They also found a tripled risk of neuropsychological deficits in children with all four risk factors.

"Hopefully, findings such as those of Fasteneau et al. will begin shaping educational policy by highlighting the direct cognitive effects associated with epilepsy," state the authors of an accompanying editorial. "Even in the absence of proper school-based evaluations, the high frequency of neuropsychological impairment at the time of diagnosis provides a compelling rationale for neuropsychological evaluation of all children newly diagnosed with epilepsy since they have normal achievement test scores at diagnosis, and there is a window of opportunity during which proper intervention may lessen the long-term cognitive burden of this disease."

Several researchers of the study and editorial and their spouses reported financial relationships with Eli Lilly, GlaxoSmithKline, and other pharmaceutical companies.

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