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Experts Urge Cognitive Testing of Kids With Epilepsy

Underlying brain abnormalities may cause learning problems, study finds,,

WEDNESDAY, Aug. 12 (HealthDay News) -- Children recently diagnosed with epilepsy should have their language, memory, learning and other cognitive skills tested because they're at increased risk for problems, say U.S. researchers.

The recommendation stems from a study of 282 school-age children with an IQ of at least 70 who had experienced their first epileptic seizure within the previous three months. The researchers looked at additional risk factors for cognitive problems, including multiple seizures, use of epilepsy drugs and signs of epilepsy on early tests of brain waves. For comparison, they examined the same data for 147 of the children's seizure-free siblings.

Among the children who'd had at least one seizure, 27 percent showed cognitive difficulties at or near the time of the first seizure, and 40 percent of children who had additional risk factors showed signs of cognitive problems. Children with all four risk factors were three time more likely to have cognitive problems by their first clinic visit than were children who'd not had seizures.

"Our study highlights the importance of testing children with epilepsy for possible cognitive problems soon after they are diagnosed with epilepsy in order to avoid these issues affecting them later in life, especially if they have additional risk factors," Philip Fastenau, a professor of neurology at Case Western Reserve University School of Medicine and the Neurological Institute of University Hospitals in Cleveland and an author of the study, said in a news release from the American Academy of Neurology.

Fastenau and his colleagues also found that children who took epilepsy drugs had problems associated with processing speed, language, verbal memory and learning, compared with children who didn't take epilepsy drugs.

"Children who take these medications should be closely monitored for cognitive problems resulting from the epilepsy drug," Fastenau said.

"Surprisingly, our study also found that academic achievement in these children was unaffected around the time of the first visit, about three months after the first seizure in this study, suggesting there is a window early in epilepsy for intervention to avoid hurting a child's performance at school," he said.

However, David Loring, of Emory University in Atlanta, said in an accompanying editorial that, because the cognitive problems were noted near the time of the first seizure, it was clear that neither the epilepsy nor the drugs caused the cognitive difficulties.

"It provides strong evidence that these cognitive problems can be attributed to underlying brain abnormalities that lead to epilepsy, rather than from extended exposure to epilepsy drugs or the effect of numerous seizures," Loring said.

The study appears online Aug. 12 in Neurology.

More information

The American Academy of Family Physicians has more about epilepsy.

-- Robert Preidt

SOURCE: American Academy of Neurology, news release, Aug. 12, 2009

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