Cognitive profiles in childhood epilepsy and the influence of identified risk factors

Principal Investigator: Cynthia Salorio

Epilepsy is often associated with a host of neurobehavioral comorbidities, including cognitive, psychiatric, and social abnormalities. Such abnormalities contribute to difficulties across occupational, academic, and adaptive domains of functioning. Childhood onset epilepsy is the most common pediatric neurologic disorder, frequently co-occurring with cognitive abnormalities. The cognitive abnormalities associated with childhood epilepsy can occur across neuropsychological domains of intelligence, language, memory, visual-spatial, visual-perceptual, sensorimotor, attention, and executive functions. However, the neuropsychological presentation of childhood epilepsy is highly variable within and across epileptic syndromes, with no clear neuropsychological phenotype.

Such variability in neuropsychological functioning has led researchers to suggest that neuropsychological functioning may be more dependent on other factors other than epileptic syndrome. Select risk factors for neuropsychological impairment have been identified, including early age of seizure onset, higher seizure frequency, increased EEG abnormalities, polypharmacy, and symptomatic versus idiopathic presentation. However, research remains somewhat inconsistent in the influence of such risk factors on neuropsychological functioning.

This project proposes to further evaluate risk factors for neuropsychological impairments in childhood epilepsy within the domains of intellectual, emotional-behavioral, and executive functioning. In addition to assessing the influence of previously identified risk factors on neuropsychological functioning at the time of evaluation, we will also assess the influence of other variables, such as a history of febrile seizures and time since seizure onset. Further, the similarities and differences between intellectual, emotional-behavioral, and executive functioning and their dependence on risk factors will also be examined. Such findings will ideally contribute to the field by providing clinicians with more specific information on risk factors associated with neuropsychological functioning at the time of the evaluation, thus contributing to the high utility of clinical neuropsychological assessment in childhood epilepsy treatment.

This study will be a retrospective record review of children and adolescents with epilepsy who received an outpatient neuropsychological evaluation at Kennedy Krieger Institute from January 2010 through December 2013. Existing medical data collected as part of routine clinical care during the outpatient neuropsychological evaluation at Kennedy Krieger Institute will be extracted.