Cognitive impairment in children with epilepsy

Introduction. Epilepsy makes its debut in childhood and adolescence, being one of the main diseases in pediatric neurology. Epilepsy in children can often lead to significant cognitive disorders.

The purpose of the work is to identify the features of mental and cognitive development of children with epilepsy.

Material and methods. A group of 929 children aged 2-11 years with different forms of epilepsy was examined. Depending on the age and severity of the disease, the children underwent a complete neuropsychological examination with in-depth study of verbal-mnestic and speech functions, or a survey based on a specially developed “mental development profile” for children with mental disabilities. For children with preserved intelligence, the method of syndrome analysis was adapted and applied. Based on the results of testing, qualitative and quantitative assessment of the parameters of the analyzed processes was carried out. The “mental development profile” for the child was displayed graphically, with the introduction of quantitative and qualitative assessments of certain areas of cognitive activity. Electrophysiological, neuroimaging and standard clinical diagnostic methods were used in all children.

Results. The specificity of neuropsychological deficiency in children with epilepsy is determined by the locus of epiactivity. The peculiarity of the deviant type of formation of mental functions is manifested in children already at the early stages of epilepsy, it is associated with dysfunction of different brain zones due to the negative impact of epileptiform activity.

Neuropsychological syndromes in different forms of epilepsy are variable, their psychological content is determined by factors related to the localization of the focus of epiactivity, the child’s mental development, and the severity of the disease.

The interhemispheric asymmetry of neuropsychological deficits was established for different locations of the epiactivity focus. The greatest severity of cognitive impairment is observed when the focus is located in the left hemisphere. The location of the epicenter of epiactivity in the frontotemporal regions can lead to cerebral dementia (the collapse of simple programs and purposeful subject activity), and behavior disorders.

Children with epilepsy who have an epiactivity locus in the parietal-occipital regions of the brain have violations of constructive praxis and visual-spatial gnosis, as well as difficulties in learning to read and write.

Conclusion. The neuropsychological method of studying the structural and functional foundations of mnestic, speech, and other types of cognitive activity in children with epilepsy has allowed us to establish that deviations in the development of mental functions in this category of children arise from insufficiently formed individual links of the functional system and the relationship between them. The presence of an epicenter of epilepsy in children with epilepsy at the early stages of the disease can cause a neuropsychological deficit in the development of higher mental functions.

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