Educational attainment of children with self-limited epilepsy with CentroTemporal spikes (SELECTS), other epilepsies, and without epilepsy: A retrospective cohort study

BACKGROUND: Children with epilepsy may have poorer educational outcomes-this may not be true for all epilepsy syndromes. We investigate educational attainment of children with Self-Limited Epilepsy with CentroTemporal Spikes (SELECTS) in Wales.

METHOD: A retrospective cohort study using routinely-collected data for children in Wales. We used primary care diagnosis codes to identify children (0-16 years) with SELECTS, other epilepsies, and children without epilepsy (comparators). We linked these records to Key Stage (KS) 2, 3 and 4 (ages 11,14, and 16) national educational test results (2003-2021). We performed logistic regression to analyse attainment (proportion achieving required attainment) in children with SELECTS, other epilepsies, and comparators.

RESULTS: At KS 2,3 and 4: 101,92 and 81 children with SELECTS were matched to 299,274 and 243 children with other epilepsies and comparators. A lower proportion of the SELECTS and other epilepsies groups achieved required attainment than the comparators across all key stages. After adjusting for sex, deprivation, year of study and Anti-Seizure Medications (ASM), children with SELECTS had similar achievement to comparators in KS2 and KS3:adjusted Odds Ratio (aOR,[95 %CI]) for achieving requirement:KS2:aOR=0.97[0.87-1.09];KS3:aOR=0.99[0.88-1.10]; but slightly reduced KS4 achievement:aOR=0.89,[0.80-1.00]. Children with other epilepsies were significantly less likely to achieve the requirement than comparators:KS2:aOR=0.79[0.72-0.87], KS3:aOR=0.78[0.71-0.86],KS4:aOR=0.72[0.65-0.80].

CONCLUSIONS: There was a trend for poorer educational achievement for children with SELECTS at KS4; this was only borderline statistically significant in the adjusted model. Children with other epilepsies had an increased risk of poorer attainment across all ages when compared to children without epilepsy.