No lasting cognitive impact of single seizure
MedWire News: Suffering a single unprovoked seizure does not appear to have any impact on children's later cognitive ability and educational achievement, report researchers.
Yoshimi Sogawa (Albert Einstein College of Medicine, New York, USA) and team found that these children had similar outcomes to their seizure-free siblings.
"In contrast, even children with very mild epilepsy have significantly worse educational outcomes," they write in the journal Epilepsia.
The 258 children in the study were aged a median of 5.5 years at their first or only seizure, and were followed-up for a median of 16.3 years.
During follow-up, 28% of the 153 children who suffered no further seizures had a poor educational outcome, defined as receiving special education services or having to repeat a year at school, as did 24% of 78 sibling controls, compared with 40% of the 105 children diagnosed with epilepsy.
Poor educational outcomes became more common with increasing number of seizures - it occurred in 34% versus 64% of children who suffered 2-9 and more than 10 seizures, respectively.
But the team notes: "The interpretation of this inverse trend needs caution, as this may simply indicate that the subjects with more seizures have more underlying brain dysfunction."
Among 162 children who completed neuropsychological testing at least 10 years after their first seizure, those with single seizures scored significantly better than those with epilepsy on the Test of Non-Verbal Intelligence-II, and tended to score higher on the Wide Range Achievement Test-3 reading and the Wechsler Intelligence Scales.
There were no differences between the ability of the children with single seizures and their sibling controls, however.
"Our cohort provided a unique opportunity to assess the impact of seizures in childhood on educational and cognitive function, as a majority of the children are not taking anti-epileptic drugs at present and had only one seizure, or had mild epilepsy," comment Sogawa et al.
They note that the generally mild epilepsy in the cohort was reflected in the children's neuropsychological testing outcomes, which were only slightly impacted. Yet epileptic children had significantly impaired educational outcomes.
The presence of sibling controls accounts for the effect of variables such as parental education and home environment, say the researchers who add that the finding may "indicate the presence of factors not measured in previous studies, such as labeling, stigma, and parental expectation."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Eleanor McDermid