2008
(Abst. 1.345)
Cognitive profile in children with intractable epilepsy of right parieto-occipital origin
Authors: Marcelo Lancman, Lorna Myers and R. Trobliger
Rationale:
This study analyzes the neuropsychological profiles of 8 children with intractable epilepsy of right parieto-occipital origin. The aim is to determine cognitive characteristics of children with this type of epilepsy.
Methods:
A total of 8 children with epilepsy of right parieto-occipital origin, confirmed through video-EEG monitoring, underwent neuropsychological testing as part of their comprehensive epilepsy work-up. The neuropsychological evaluation included testing of intellectual (Wechsler Intelligence Scale for Children-Fourth Edition and Wechsler Preschool and Primary Scales of Intelligence), academic (Wechsler Individual Achievement Test-Second Edition- word reading, spelling and mathematical calculations) general neuropsychological functions (NEPSY: subtests from the memory, language, attention/executive, and visual-spatial domains), and parental ratings of behavior with regards to inattention and hyperactivity (Conner’s Parent Rating Scale-Revised:Long Version). The mean age of the sample was 9 years and the mean education level was the 5.5th grade; 5 of the 6 children who were enrolled in school were classified in special education. Epilepsy duration was at a mean of 4 years. Four patients were left-handed and four were right handed.
Results:
Neuropsychological testing revealed that as a whole, the mean intellectual quotient for the sample of 8 patients was within the low average range (FSIQ=87.6). No significant discrepancies were noted between scores on predominantly verbal and visual tests. However, significantly lower scores were obtained on an arithmetic as compared to word reading and spelling tasks. In addition, elevations ranging from moderate to extreme limits were noted on parental reports of cognitive problems/inattention for all children.
Conclusions:
Item-by-item analysis of academic test forms revealed that errors involved multiple digit equations, regrouping, and decimal placements despite evidence of adequate mathematical knowledge in these areas. This is suggestive of acalculia of the spatial type, which is associated to right parietal dysfunction. Clinical range inattention was also a consistent finding and may have impacted on scores.