Abstracts

Rationale: Cross-sectional and prospective studies conducted over the past decade on children with new onset seizures and chronic epilepsy report a wide range of cognitive and behavioral problems. Yet, relatively few studies have been conducted on the linguistic skills of children with average intelligence to determine which children are at risk for linguistic deficits. This study examined if children with epilepsy are vulnerable to language deficits and how this risk is related to developmental stage by comparing the linguistic skills of a large sample of children and adolescents with epilepsy to those of age and gender matched normal children. It also examined the role played by age, seizure, cognitive, psychopathology, perinatal, and demographic variables in the linguistic skills of the epilepsy subjects within each of three age groups.Methods: 182 children with idiopathic epilepsy, aged 6 -15 years, and 123 age and gender matched normal children were administered the Test of Language Development, the Wechsler Intelligence Scale for Children-III, and structured psychiatric interviews. Parents provided demographic, seizure-related, and behavioral information. Results: The epilepsy subjects had significantly lower mean Spoken Language (SLQ) (F(1,281) = 20.07, p<.0001), Listening (LIQ) (F(1,282) = 13.60, p<.0003), and Speaking Quotient (SPQ) scores (F(1,281) = 10.85, p<.001) than the normal children. One third of the younger, 48%-78% of the intermediate, and 44%-54% of the adolescent epilepsy subjects had language scores 1 SD below average compared to 12%-20%, 11%-16%, and 17%-25%, of these respective age groups in the normal subjects. Among the younger epilepsy subjects, SLQ, LIQ, and SPQ scores 1 SD below average were significantly associated with absence epilepsy (p<.009), longer duration of illness (p<.005), and history of prolonged seizures (p<.09). In the intermediate age group, these scores were significantly related to complex partial seizures (p< .008), having a psychiatric diagnosis (p<.05), and lower Performance IQ (PIQ) scores (p<.004). Lower PIQ scores (p<.03), prolonged seizures (p<.03), febrile convulsions (p<.09), and increased seizure frequency (p<.07) predicted lower language scores in the adolescent patients.Conclusions: These findings demonstrate increased risk of impaired language skills with age and an age-related differential association with seizure, cognitive, and behavioral variables. Given the role of language in children’s academic performance, these findings emphasize the need for early detection of the predictors linguistic deficits in youth with epilepsy.