Characterization of neuropsychological manifestations in children with rolandic epilepsy

Author(s)

Ecila Paula dos Mesquita de Oliveira

• Document type: Doctoral Thesis
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2011-02-18

Examining board members

Marilisa Mantovani Guerreiro; Kette Dualibi Ramos Valente; Simone Rocha de Vasconcellos Hage; Maria Augusta Santos Montenegro; Mirela Boscariol

• Advisor: Marilisa Mantovani Guerreiro

Abstract

Benign childhood epilepsy with centro-temporal spikes (rolandic epilepsy) is the most frequent form of epilepsy in childhood. This epileptic syndrome is usually idiopathic, age-dependent, and has benign evolution. Despite the good prognosis in relation to the seizures, recent evidence show that rolandic epilepsy is not so benign, since specific cognitive deficits may occur in those patients. The aim of this study was to verify if language disorder occurs in patients with rolandic epilepsy, and if yes, we aimed to characterize the deficits, comparing the performance of our patients with a control group. We evaluated 62 subjects between March 2007 to December 2009. Children of both gender, aging from 7 to 15 years 11 months were seen. They were divided into two subgroups: 31 consecutive patients with clinical and eletrectroencephalographic findings suggestive of rolandic epilepsy (affected group = group A) and 31 subjects of control group (group C), without any neurological complaint, and matched with group A by sex, age and socio-economic level. Both groups underwent extensive neuropsychological and phonological assessments. Our findings were categorized as: a) dyslexia, characterized by difficulties in phonological awareness, recognition and fluency in decoding and spelling (reading and writing) and poor performance in short-term verbal memory; b) other difficulties, characterized by mild to moderate difficulties that may cause impairment in oral language, writing, and consequently in school learning, but do not fulfill diagnostic criteria for dyslexia.; and, c) without difficulties. Our results were compared and statistically analyzed. Our data showed that dyslexia occurred in 19,4% and other difficulties in 74,2% of our patients, and this was highly significant when compared with the control group (p = 0.001). Our findings also pointed to the following observations: comorbidity between rolandic epilepsy and speech praxis deficit may not be present; children with rolandic epilepsy may have more writing difficulties than control group; epileptiform discharges and treatment were correlated with other difficulties in patients with rolandic epilepsy; seizure frequency, age of onset and seizure type were neither correlated with dyslexia nor with other difficulties in our patients. To conclude, our data showed that children with rolandic epilepsy may present with oral and written language disturbances that may be classified as dyslexia (AU)