Abstracts

Rationale: Childhood Seizures have multiple etiologies and often result in neurobehavioral comorbidity characterized by neurocognitive deficits, learning disorders, behavioral dysfunction, and psychiatric symptomatology. Children with epilepsy do not present with easily recognized cognitive impairments nor a neurocognitive profile reflective of seizure disorder. Yet, certain cognitive functions exhibit dysfunction in children with epilepsy (Intellectual, Attention/Memory, Executive, Learning Ability). The Meyers Neuropsychological System (MNS) scoring system utilizing the integration of a modified Rohling Interpretive Method and profile matching approach, allowing comparison of a patient reference group's data, with that of the examiner's patient. Patients in the reference group were classified by side of epileptiform activity, or as Primary Generalized seizures, by positive EEG findings and diagnostic evaluation by Board Certified neurologists/epileptologists. This system facilitates differential diagnosis and treatment planning. The goal of the present pilot study was to determine if data of pediatric patients with epilepsy would match with those of reference group patients with epilepsy. Methods: The MNS was administered as part of a neuropsychological evaluation of children referred by pediatric neurology. The MNS battery of tests consists of a "core" battery of tests used for the data base. The subjects were five pediatric neurology patients (4M and 1F), ages 7,8,12, 17 and 19. All five subjects were administered the "core" battery of tests as part of their routine neuropsychological evaluation and the MNS was used to compare their domain profiles to reference group data for patients with Epilepsy classified as Right, Left, or Primary Generalized. Each subject had a formal diagnosis of seizure disorder and three of them had EEG data read by a Board Certified Pediatric Neurologist/Epileptologist. Two scores were obtained for each of three reference group conditions (Right, Left, Primary Generalized): a Pearson correlation coefficient was calculated comparing the subjects data with reference group data. A Configuration score was calculated, indicating how many of the subject's scores are in the same general direction as that of comparison group data (.3 and .59 minimum respectively). Results: When each subject's data was compared to that of the referrence groups, there were significant correlations between the profiles. All five subjects exhibited significant correlations with at least two of the comparison groups, indicating that the MNS is a viable system for obtaining data that can be meaningfully compared with that of patients with documented seizure disorders. Conclusions: The results of the present study support the utility of the MNS for use with neuropsychological assessment of pediatric patients with seizure disorders. The program generates correlation coefficients and strength of pattern consistence that provides a visual representation of the child's data as compared to that of the comparison group for each disorder, allowing for hypothesis testing and differential diagnosis.