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Neurocognitive development of children with congenital unilateral brain lesion and epilepsy

      Abstract

      The aim of this study was to specify the neuropsychological deficits characteristic of children with unilateral non-progressive brain lesion. In order to assess these specific functions, we used a comprehensive model of congenital hemiparesis with partial epilepsy and newly diagnosed partial epilepsy without hemiparesis. The neuropsychological examination was performed using the NEPSY test battery on 44 children aged from 4 to 9 years. The children were divided into three groups: 18 children suffering from congenital hemiparesis with chronic partial epilepsy, 12 children with newly diagnosed partial epilepsy prior to anti-epileptic treatment, and 14 healthy controls matched by sex, age, and socioeconomic status. Children with congenital hemiparesis and epilepsy had a more clearly expressed cognitive dysfunction, especially in language, visuo-perceptual and memory tasks, than children with newly diagnosed partial epilepsy. The profile of cognitive weakness appears to be diffuse and quite similar in both groups, and it did not demonstrate a clear effect of lateralization, according to the side of epileptic electroencephalogram discharges. Children within both groups are likely to have a high risk of developing attention, phonological, visuo-perceptual, and memory deficits in their life. Especially interesting and surprising was the fact that the newly diagnosed epilepsy group demonstrated impairment not only in attention, visuo-perceptual and short-term memory skills, but also in auditory perception, lexical function, and the comprehension of speech. Therefore, it is recommended that children with epilepsy would undergo neuropsychological examination in order to assess their cognitive abilities.

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      References

        • Vargha-Khadem F
        • Isaacs E
        • van der Werf S
        • Robb S
        • Wilson J
        Development of intelligence and memory in children with hemiplegic cerebral palsy. The deleterious consequences of early seizures.
        Brain. 1992; 115: 315-329
        • Vargha-Khadem F
        • Isaacs E
        • Muter V
        A review of cognitive outcome after unilateral lesions sustained during childhood.
        J Child Neurol. 1994; 9: 67-73
        • Riva D
        • Cazzaniga L
        Late effects of unilateral lesions sustained before and after age one.
        Neuropsychologia. 1986; 24: 423-428
        • Riva D
        Sequelae of early focal lesions.
        in: Perat M.V New developments in child neurology. VIII International Child Neurology Congress, Ljubljana, Slovenia, 13–17 September 1998. Monduzzi, Bologna1998: 61-66
        • Riva D
        • Pantaleoni C
        • Milani N
        • Giorgi C
        Hemispheric specialization in children with unilateral epileptic focus with and without computed tomography-demonstrated lesion.
        Epilepsia. 1993; 34: 69-73
        • Deonna T
        Cognitive and behavioral disturbances as epileptic manifestations in children: an overview.
        Semin Pediatr Neurol. 1995; 2: 254-260
        • Wada J.A
        • Clark R
        • Hamm A
        Cerebral hemispheric asymmetry in humans.
        Arch Neurol. 1975; 32: 239-246
        • Satz P
        • Strauss E
        • Whitaker H
        The ontogeny of hemispheric specialization: some old hypothesis revisited.
        Brain Lang. 1990; 38: 596-614
        • Kolk A
        • Talvik T
        Cognitive development of children with hemiparesis.
        in: Perat M.V New developments in child neurology. VIII International Child Neurology Congress, Ljubljana, Slovenia, 13–17 September 1998. Monduzzi, Bologna1998: 689-693
        • Kolk A
        • Talvik T
        Cognitive outcome of children with early-onset hemiparesis.
        J Child Neurol. 2000; 9: 581-587
        • Talvik T
        • Soot A
        • Soopold T
        • Rammel T
        • Lutsar I
        • Talvik I
        Psühhomotoorse arengu skaala. Tartu University Press, Tartu1994
        • Kaufman A.S
        • Kaufman N.L
        Kaufman assessment battery for children. American Guidance Service, Circle Pines, MN1983
        • Kotlarek F
        • Rodewig R
        • Brull D
        • Zeumer H
        Computed tomographic findings in congenital hemiparesis in childhood and their relation to etiology and prognosis.
        Neuropediatrics. 1981; 12: 101-109
        • Korkman M
        NEPSY. Lasten neuropsyckologien tutkimus. Psykologien Kustannus Oy, Helsinki1988
        • Korkman M
        NEPSY – an adaptation of Luria's investigation for young children.
        Clin Neuropsychol. 1988; 2: 375-392
        • Korkman M
        • Kirk U
        • Kemp S.L
        NEPSY. A developmental neuropsychological assessment. Test materials and manual. Psychological Corporation, San Antonio, TX1998
        • Korkman M
        A test profile approach in the analysis of cognitive disorders in children – experiences of the NEPSY.
        in: Tramontana M.G Hooper S.R Advances in child neuropsychology. Springer-Verlag, New York1995: 75-96
        • Isaacs E
        • Christie D
        • Vargha-Khadem F
        • Mishkin M
        Effects of hemispheric side of injury, age at injury, and presence of seizure disorder on functional ear and hand asymmetries in hemiplegic children.
        Neuropsychologia. 1996; 34: 127-137
        • Holmes G.L
        Epilepsy in the developing brain: lessons from the laboratory and clinic.
        Epilepsia. 1997; 38: 12-30
        • Dikmen S
        • Matthews C.G
        • Harley J.P
        The effect of early versus late onset of major motor epilepsy upon cognitive-intellectual performance.
        Epilepsia. 1975; 16: 73-81
        • Brown S.W
        Epilepsy dementia: intellectual deterioration as a consequence of epileptic seizures.
        in: Sillanpää M Gram L Epilepsy and mental retardation. Wrightson Biomedical, Petersfield, PA1999: 115-134
        • Rabinowicz A.L
        • Correale J
        • Boutros R.B
        • Couldwell W.T
        • Henderson C.W
        • DeGiorgio C.M
        Neuron-specific enolase is increased after single seizures during inpatient video/EEG monitoring.
        Epilepsia. 1996; 37: 122-125
        • During M.J
        • Spencer D.D
        Extracellular hippocampal glutamate and spontaneous seizure in the conscious human brain.
        Lancet. 1993; 341: 1607-1610
        • Muller R.A
        • Behen M.E
        • Rothermel R.D
        • Muzik O
        • Chakraboty P.K
        • Chugani H.T
        Brain organization for language in children, adolescents, and adults with left hemisphere lesion: a PET study.
        Prog Neuro-Psychopharmacol Biol Psychiatry. 1999; 23: 657-658
        • Nezu A
        • Kimura S
        • Taksshita S
        • Tanaka M
        Functional recovery in hemiplegic cerebral palsy: ipsilateral electromyographic responses to focal transcranial magnetic stimulation.
        Brain Dev. 1999; 21: 162-165
        • Korkman M
        Applying Luria's diagnostic principles in the neuropsychological assessment of children.
        Neuropsychol Rev. 1999; 2: 89-105
        • Mitchell W.G
        Behavioral, cognitive, and social difficulties in childhood epilepsy.
        in: Swaimann K.E Stephen A Pediatric neurology. Principles and practice. 3rd ed. Mosby, St. Louis, MO1999: 742-746
        • Koeda T
        • Takeshita K
        Visuo-perceptual impairment and cerebral lesions in spastic diplegia with preterm birth.
        Brain Dev. 1992; 14: 239-244
        • Roberts R.J
        • Varney N.R
        • Paulsen J.S
        • Richardson E.D
        Dichotic listening and complex partial seizures.
        J Clin Exp Neuropsychol. 1990; 12: 448-459
        • Bishop D.V.M
        How does the brain learn language? Insights from the study of children with and without language impairment.
        Dev Med Child Neurol. 2000; 42: 133-142
        • Gordon K
        • Bawden H
        • Camfield P
        Valproic acid treatment of learning disorders and severely epileptiform EEG without clinical seizures.
        J Child Neurol. 1996; 11: 41-43
        • Weglage J
        • Demsky A
        • Pietsch M
        • Kurlemann G
        Neuropsychological, intellectual, and behavioral findings in patients with centrotemporal spikes with and without seizures.
        Dev Med Child Neurol. 1997; 39: 646-651
        • Aldenkamp A.P
        • Overweg J
        • Gutter T
        • Beun A.M
        • Diepman L
        • Mulder O.G
        Effect of epilepsy, seizures and epileptiform EEG discharges on cognitive function.
        Acta Neurol Scand. 1996; 93: 253-259
        • Tuchman R.F
        • Rapin I
        Regression in pervasive developmental disorders: seizures and epileptiform electroencephalogram correlates.
        Pediatrics. 1997; 99: 560-566
        • Sillanpää M
        • Jalava M
        • Kaleva O
        • Shinnar S
        Long-term prognosis of seizures with onset in childhood.
        N Engl J Med. 1998; 338: 1715-1722
        • Kokkonen J
        • Kokkonen E.R
        • Saukkonen A.L
        • Pennanen P
        Psychosocial outcome of young adults with epilepsy in childhood.
        J Neurol Neurosurg Psychiatry. 1997; 62: 265-268
        • Mitchell W.G
        • Chavez J.M
        • Lee H
        • Guzman B.L
        Academic underachievement in children with epilepsy.
        J Child Neurol. 1991; 6: 65-72
        • Carlsson G
        • Uvebrant P
        • Hugdahl K
        • Arvidsson J
        • Wiklund L.M
        • Wendt L
        Verbal and non-verbal function of children with right- versus left-hemiplegic cerebral palsy of pre- and perinatal origin.
        Dev Med Child Neurol. 1994; 36: 503-512