Benign partial epilepsy of childhood: a longitudinal neuropsychological and EEG study off cognitive function

The study combined prospective neuropsychological and EEG results of 28 chi ldren presenting with typical benign partial epilepsy with rolandic spikes (n = 19) and occipital spikes (n = 3). The aims were to assess the types of cognitive problems which may be encountered in this population, to evaluat e the course of cognitive and learning capacities during the active phase o f epilepsy, and to see if there was a correlation with paroxysmal activity on the EEG. Average age at entry in the study was 8.4 sears and each child was seen two to four times over a period of 1 to 3 sears. EEGs showed persi stent spike foci in most cases that worsened in three cases, but there were no continuous spike-waves during sleep. No child had persistent stagnation , marked fluctuations, or a regression in cognitive abilities. Of 22 childr en, al had average IQ (>80). Eight children had school difficulties requiri ng special adjustment. No single cognitive profile was identified. Four chi ldren had delayed language development and eight children had transient wea k scores in one isolated domain (verbal,visuospatial, memory) which improve d or normalized during the course of the study with concomitant EEG improve ment or normalization. In two of the three children with aggravation of the paroxysmal EEG activity, clinical changes were documented. A proportion of children with typical benign partial epilepsy with rolandic spikes showed mild, varied, and transient cognitive difficulties during the course of the ir epilepsy, and in most cases this probably had a direct relation with the paroxysmal EEG activity.