14-12-2015 | Cognitive Screening Tool Useful in Clinic For Children With Epilepsy

14 December 2015
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New research supports the use of a portable, and easy-to-use computerized cognitive screen for children with a recent epilepsy diagnosis.

Cognitive difficulties are a concern for families and for clinicians alike with families being concerned about the impact on their child's academic achievement, according to Dr. Miya Asato,of the Children's Hospital of Pittsburgh, Pennsylvania, going on to state "All of us who work in pediatric epilepsy are concerned about the effects of ongoing seizures in children who are undergoing critical periods of cognitive development."

Cognitive issues often occur before the onset of seizures according to Dr. Asato and " these deficits are often not acknowledged or addressed. Neuropsychological screening is not routinely available for all children attending epilepsy clinics despite some of those children being at risk of cognitive deficits. The emphasis needs to be on identifying the children at most risk of developing deficits.

Dr. Asato explained that a brief computerized cognitive assessment battery during the clinic visit might pick up indicators of cognitive deficits and or treatment related effects on cognition that would help clinicians make treatment decisions. The tests included standard neuropsychological tests of continuous performance test, reaction time, visual and verbal memory. The cognitive screening tool can be used on a laptop, and takes 35 minutes to complete but is not a diagnostic tool.

The research study included 43 children with epilepsy aged 8 to 17 years who were on a variety of medications. They were screened after diagnosis but before starting medication. Of these, 33 had a second test and 16 a third test between 5 and 14 months later respectively. Results showed that at the first test stage, the children as a group were performing within average range on many of the cognitive tests. Then the research look at subsequent changes in performance and found that that 85% had statistically significant changes in performance in one or more measures in the computerized battery at the second testing. Only very few patients had no change in memory, psychomotor speed, reaction time, complex attention or cognitive flexibility. However, these changes did not appear to be significantly related to medication, seizure type, or seizure control. There are a lot of changes but it's multifactorial. From their findings the research team developed an algorithm to help identify high-risk patients in clinical settings with children with declining scores and parental concerns about academic achievement warranting the most prompt response and those with stable scores requiring observation or referral for assessment where there are parental concerns.

Source: American Epilepsy Society (AES) 69th Annual Meeting. Abstract 1.293.


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