Cognition in pediatric patients with diagnosis of epilepsy
DOI:
https://doi.org/10.5281/zenodo.10998749Keywords:
Cognition, Epileptic Syndromes, Memory, EpilepsyAbstract
Background: Epilepsy affects from 0.5 to 1% of children worldwide and has a cognitive impact on the patient.
Objective: To assess cognitive characteristics in pediatric patients diagnosed with epilepsy.
Material and methods: Analytical, cross-sectional study of patients with epilepsy aged 6 to 16 years in a tertiary hospital in Puebla, Mexico. Type of epilepsy, evolution, treatment, and school performance were evaluated. The Wechsler Intelligence Scale IV was used for cognitive characteristics. Mann-Whitney U and phi coefficients were used. It was considered statistically significant a p < 0.05.
Results: 95 patients were included, 61.1% were male. Mean: age 11.16 years (± 2.5), school performance 7.8 (± 0.99), time of development: 2.4 years (± 1.4). They were schoolchildren aged 6-11 years (36.8%) and adolescents aged 12-16 years (63.2%); 79% had generalized epilepsy; 93.6% were treated with monotherapy (47.3% with magnesium valproate). The mean intellectual quotient was 90.3 (± 10.02), decreased in 12 patients (12.6%). Working memory was the most commonly affected domain (31.6%), mostly in adolescents with 40% (p = 0.021). Perceptual reasoning and working memory were significantly correlated with developmental time (phi = 0.17, p = 0.04 and phi = 0.49, p < 0.001, respectively).
Conclusions: Working memory was the most affected cognitive characteristic, especially in adolescents. Working memory and perceptual reasoning were affected by time of development.
Downloads
References
Hernández García E, Naranjo L, Pichardo-Macías LA, et al. Analysis of adverse drug reactions in pediatric patients with epilepsy: An intensive pharmacovigilance study. Children (Basel). 2023;10(11). doi: 10.3390/children10111775.
Cruz-Cruz MDR, Gallardo-Elías J, Paredes-Solís S, et al. Factores asociados a epilepsia en niños en México: un estudio caso-control. Bol Med Hosp Infant Mex. 2017;74(5):334-40. doi: 10.1016/j.bmhimx.2017.05.006.
Bahagat KA, Elhady M, Aziz AA, et al. Cociente omega-6/omega-3 y cognición en niños con epilepsia. An Pediatr (Engl Ed). 2019;91(2):88-95. doi: 10.1016/j.anpedi.2018.07.015.
Valdes-Galvan RE, Gonzalez-Calderon G, Castro-Martinez E. Epidemiología del descontrol de la epilepsia en un servicio de urgencias neurológicas. Rev Neurol. 2019;68(8):321-5. doi: 10.33588/rn.6808.2018218.
Park YW, Choi YS, Kim SE, et al. Radiomics features of hippocampal regions in magnetic resonance imaging can differentiate medial temporal lobe epilepsy patients from healthy controls. Sci Rep. 2020;10(1). doi: 10.1038/s41598-020-76283-z.
Echevarría-Ramírez LM. Trastornos del neurodesarrollo y su impacto en las funciones cognitiva. Neuronup.com; 2 de noviembre de 2023. Disponible en: https://www.neuronup.com/estimulacion-y-rehabilitacion-cognitiva/trastornos-del-neurodesarrollo/trastornos-del-neurodesarrollo-y-su-impacto-en-las-funciones-cognitiva/
Kim EH, Ko TS. Cognitive impairment in childhood onset epilepsy: up-to-date information about its causes. Korean J Pediatr. 2016;59(4):155. doi: 10.3345/kjp.2016.59.4.155.
Lee SK. Diagnosis and treatment of status epilepticus. J Epilepsy Res. 2020;10(2):45-54. doi: 10.14581/jer.20008.
Burman RJ, Selfe JS, Lee JH, et al. Excitatory GABAergic signalling is associated with benzodiazepine resistance in status epilepticus. Brain. 2019;142(11):3482-501. doi: 10.1093/brain/awz283.
Lawton B, Davis T, Goldstein H, et al. An update in the initial management of paediatric status epilepticus. Curr Opin Pediatr. 2018;30(3):359-63. doi: 10.1097/mop.0000000000000616.
World Health Organization. Epilepsy. Geneva: WHO; updated 7 February 2024. Disponible en: https://www.who.int/news-room/fact-sheets/detail/epilepsy.
Consejo General de Colegios Oficiales de Psicólogos. Evaluación del test WISC-IV. Madrid, España: Consejo General de Colegios Oficiales de Psicólogos; 2012. Disponible en: https://www.cop.es/uploads/PDF/WISC-IV.pdf.
Rosas R, Tenorio M, Pizarro M, et al. Estandarización de la Escala Wechsler de Inteligencia Para Adultos-Cuarta Edición en Chile. Psykhe. 2014;23(1):1-18. doi: 10.7764/psykhe.23.1.529.
Pérez-Jara C, Ruíz Y. Evaluación neuropsicológica en niños con trastornos del neurodesarrollo. Rev Médica Clín Las Condes. 2022;33(5):502–11. doi: 10.1016/j.rmclc.2022.07.007.
Albornoz Zamora EJ, del Carmen Guzmán M. Desarrollo cognitivo mediante estimulación en niños de 3 años: Centro Desarrollo Infantil Nuevos Horizontes. Quito, Ecuador. Universidad y Sociedad. 2016;8(4):186-92. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2218-36202016000400025.
Auvin S. Paediatric epilepsy and cognition. Dev Med Child Neurol. 2022;64(12):1444-52. doi: 10.1111/dmcn.15337.
Ofer I, Jacobs J, Jaiser N, et al. Cognitive and behavioral comorbidities in Rolandic epilepsy and their relation with default mode network’s functional connectivity and organization. Epilepsy Behav. 2018;78:179-86. doi: 10.1016/j.yebeh.2017.10.013.
Sousa E, Pinto M, Ferreira M, et al. Comorbilidades neurocognitivas y psicológicas en pacientes con epilepsia de la infancia con puntas centrotemporales. Un estudio de casos y controles. Rev Neurol. 2023;76(5):153-8. doi: 10.33588/rn.7605.202238...
Stewart E, Lah S, Smith ML. Patterns of impaired social cognition in children and adolescents with epilepsy: The borders between different epilepsy phenotypes. Epilepsy & Behaviour. doi: 10.1016/j.yebeh.2019.01.031.
Hunt R, Ellis H. Fundamentos de Psicología cognitiva. México: Manual Moderno; 2007.
Schmidlechner T, Zaddach M, Heinen F, et al. IQ changes after pediatric epilepsy surgery: a systematic review and meta-analysis. J Neurol. 2024;271(1):177-87. doi: 10.1007/s00415-023-12002-8.
Soto Insuga V, González Alguacil E, García Peñas JJ. Estado epiléptico pediátrico. Rev Neurol. 2022;75(08):225. doi: 10.33588/rn.7508.2022196.
Walker MC. Pathophysiology of status epilepticus. Neurosci Lett. 2018;667:84-91. doi: 10.1016/j.neulet.2016.12.044.
Santamarina E, Abraira L, Toledo M. Actualización en el estado de mal epiléptico (status epilepticus). Med Clin (Barc). 2019;153(2):70-7. doi: 10.1016/j.medcli.2019.01.013.
Reséndiz-Aparicio JC, Pérez-García JC, Olivas-Peña E, et al. Guía clínica. Definición y clasificación de la epilepsia. Revista Mexicana de Neurociencia. 2023;20(2). Disponible en: https://www.revmexneurociencia.com/files/es/rmn_19_20_2_007-012.pdf.
Jungilligens J, Michaelis R, Popkirov S. Misdiagnosis of prolonged psychogenic non-epileptic seizures as status epilepticus: epidemiology and associated risks. J Neurol Neurosurg Psychiatry. 2021;92(12):1341-5. doi: 10.1136/jnnp-2021-326443.
Moosa ANV. Antiepileptic drug treatment of epilepsy in children. Continuum (Minneap Minn). 2019;25(2):381-407. doi: 10.1212/con.0000000000000712.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Revista Médica del Instituto Mexicano del Seguro Social
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain their copyright and grant the Revista Médica del IMSS the right of first publication. Articles are distributed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows sharing as long as the author and the original source are properly credited.
