What is it about?

Previous reports of cognitive profiles in children and adolescents with temporal lobe epilepsy (TLE) are highly inconsistent and variable across studies. In this study, we attempted to better describe the continuum of cognitive skills in pediatric epilepsy. Key questions: are there distinct cognitive profiles (aka phenotypes) related to pediatric TLE? And, if so, how do these profiles relate to other child-specific factors, like seizure or demographic factors? To explore our these questions, we used a relatively novel approach (cluster analysis). We identified three unique cognitive profiles: (1) normal functioning (20% of sample); (2) delayed verbal memory and motor weaknesses (61% of the sample); and (3) global impairment (19% of the sample). Children with greater cognitive challenges also had a longer duration of epilepsy and greater risk for structural changes to the brain.

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Why is it important?

Temporal lobe epilepsy is one of the most common forms of focal epilepsy affecting children and adolescents. The present work provides an alternative means to explore and describe the differential impact of TLE on the developing brain. It also provides partial evidence for the cognitive skills that may be most vulnerable to the TLE disease process. It is hoped that this work will provide helpful clues to assist with early detection and, ultimately, more precise management. More specifically, a better understanding of distinct cognitive phenotypes may facilitate future research in other epilepsy syndromes, such as identifying developmental trajectory and associated clinical, neuroanatomical, psychosocial characteristics. This, in turn, has the hope of improving treatment and quality of life outcomes.

Perspectives

Writing this article was a great pleasure as it has co-authors with whom I have had a long standing collaborations. More than anything, and if nothing else, I hope you find this article thought-provoking.

William Schraegle
Dell Medical School, The University of Texas at Austin

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This page is a summary of: Neuropsychological Phenotypes in Pediatric Temporal Lobe Epilepsy, Journal of the International Neuropsychological Society, August 2021, Cambridge University Press, DOI: 10.1017/s1355617721001090.
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