Determinants of cognitive impairment in children with epilepsy in Benin City

Abstract

Background: Seizures during the critical period of cerebral maturation in children may interfer with neuro developmental changes in their brain.  This may lead to widespread impairments in a child’s neurological development and manifest as cognitive problems.
Objective: The aim of the study was to determine the prevalence of cognitive impairment as well as its determinants in children with epilepsy (CWE)  attending the Child Neurology Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria.
Subjects and Methods: One hundred and sixty CWE (comprising 80 treatment naive and 80 on treatment) aged 6-16 years were recruited for the  study. Cognitive functions were evaluated using the Wechsler’s intelligence scale for children (4th edition).
Results: Prevalence of cognitive impairment was 55%. Children with epilepsy on treatment had a higher prevalence of cognitive impairment (63.8%) compared to the newly diagnosed who were not on antiepileptic drug (AED) treatment (46.3%) .Twenty- nine (18.1%) of the subjects had scores  consistent with a diagnosis of intellectual disability (FSIQ<70). Age group (p<0.01), socioeconomic class (p<0.01), age at onset of seizure (p<0.01) and  type of seizures (p<0.01) were significantly associated with cognitive impairment in bivariate analysis. However, in a multivariable logistic regression model, only socioeconomic class and age at onset of seizure remained significant.
Conclusion/Recommendation: The findings of this study highlight the need for evaluation of cognitive performance of CWE periodically, especially  those on AED treatment. Early intervention programs to improve the cognitive function would be beneficial for the overall development of CWE. In  addition, future longitudinal studies should shed more light on the influence of AED on cognitive performance of CWE.