The combined burden of cognitive, executive function, and psychosocial problems in children with epilepsy: a population-based study

The combined burden of psychosocial (Achenbach scales), cognitive (Raven matrices), and executive function (EF) problems was studied in a population-based sample of 6- to 12-year-old children with epilepsy (n=162; 99 males, 63 females) and in an age- and sex-matched control group (n=107; 62 males, 45 females). Approximately 35% of the children with epilepsy had severe non-verbal cognitive problems. In those that did not, mild cognitive problems (26% vs 11%, p=0.005), EF problems (31% vs 11%, p < 0.001), and psychosocial problems (45% vs 10%, p < 0.001) were each much more common than among controls. Having problems in two or all three of these areas simultaneously was more frequent among the children with epilepsy (14% vs. 3%, p < 0.001 and 4% vs 0%, p < 0.001 respectively). Excluding those having remote symptomatic epilepsy aetiology did not change the problem load significantly for the children with epilepsy with the important exception that having severe non-verbal problems was approximately halved from 35 to 18%. In 30 children with benign epilepsy of childhood with centrotemporal spikes, mild cognitive problems were somewhat more common, but psychosocial and EF problems were similar compared with control children.