A neuropsychological assessment, using computerized battery tests (CANTAB), in children with benign rolandic epilepsy before AED therapy

Rationale: Benign rolandic epilepsy (BRE) is a form of partial idiopathic epilepsy according to the International League Against Epilepsy (ILAE) syndromes classification (1989). Recent studies have identified cases of BRE that do not meet the initial definition of ‘benign’; these included reports of cases with specific cognitive deficits. It is still a matter of debate, whether these deficits are due to epilepsy per se, to treatment or other associated factors. Objectives: The aim of this study was to evaluate if BRE children have cognitive deficits at the onset of their seizures, prior to their participation in any anti-epileptic drug therapy (AED). Methods and Results: We performed a neuropsychological assessment of 18 BRE children compared with a corresponding age-matched control group. We used the Cambridge Neuropsychological Test Automated Battery (CANTAB). Subjects were at their first neurological evaluation, before any AED therapy. We assessed: visual memory, induction and executive functions. In our group, the BRE children performed comparably with the control children for the induction and executive functions. Substantial differences were identified for the visual memory subtests: PRM percent correct (t = -2.58, p = 0.01) and SRM percent correct (t = -2.73, p = 0.01). Age of seizure onset had a negative impact on the visual memory subtest performances (PRM mean correct latency). We found significant correlations between the different CANTAB subtests results and characteristics of the centrotemporal spikes (CTS). Discussion: Our results are consistent with the findings of other similar studies. This form of epilepsy is associated with subtle neuropsychological deficits, present at seizure onset. Neuropsychological deficits identified, suggest a more diffuse brain involvement in the epileptiform process. Abbreviations: AED – AntiEpileptic Drug; BECTS - benign childhood epilepsy with centrotemporal spikes; BRE – Benign Rolandic Epilepsy; CANTAB - the Cambridge Neuropsychological Test Automated Battery; CTS – centrotemporal spikes; DMS – Delayed Matching Sample; EEG – electroencephalogram; ILAE – International league Against Epilepsy; MOT – Motor screening Test; PAL - Paired Associates Learning; PRM - Pattern Recognition Memory; SPSS - Statistical Package for the Social Sciences; SRM - Spatial Recognition Memory; SSP - Spatial Span, SWM - Spatial Working Memory