Abstracts

Rationale: Children with new onset epilepsy demonstrate mild cognitive deficits, learning disabilities and psychiatric disorders, collectively referred to as neurobehavioral comorbidites of epilepsy. While these are in part attributable to seizures and medication regimen, there is also evidence that some comorbidities may predate the onset of seizures. This study describes temporal patterns of neurobehavioral comorbidities among a sample of children with new onset epilepsy. Methods: Data from 34 pediatric epilepsy patients (ages 5-17) was collected via record review. All patients were diagnosed with epilepsy and completed formal neuropsychological testing within one year of diagnosis. Information collected from the record included age, time between initial diagnosis and testing, seizure type, epileptogenic focus, antiepileptic medication regimen, cognitive test scores, history of academic concerns, parent questionnaire scores and DSM-IV diagnoses. Results: This sample of new onset epilepsy patients had higher than normal prevalence of ADHD (35%), learning disability (15%), and anxiety disorders (18%) in comparison to base rates in the non-epilepsy population. Patients with generalized epilepsy showed slower processing speed (PSI=84) than patients with focal epilepsy (PSI=99) (t=3.002, p=.005). Language-based cognitive test scores were significantly lower for patients who were tested later in their epilepsy course. There was a significant relationship between this time difference and verbal comprehension (r=-.423, p=.013), confrontation naming (r=-.375, p=.035) and comprehension of instructions(r=-.404, p=.022). These relationships persisted after excluding left-sided seizure focus as a potential covariate. Conclusions: Preliminary data analysis indicates that children with new onset epilepsy have higher prevalence of neurobehavioral comorbidities such as ADHD, learning disability, and anxiety disorders. Further, children with newly diagnosed generalized epilepsy showed significantly slower processing speed than children with newly diagnosed focal epilepsy. These findings are consistent with previous research in children with new onset epilepsy. Extending previous research within this population, the current study found a significant association between time from diagnosis to testing, and language-based cognitive abilities. Surprisingly, patients who underwent testing later in their relatively short epilepsy course, showed significantly worse verbal cognitive abilities than who underwent testing earlier. This is especially notable given that the time differences were only a matter of months. These findings highlight the importance of establishing a cognitive baseline as soon as possible after initial diagnosis among children with new onset epilepsy.