Intelligence and memory outcomes within 10 years of childhood convulsive status epilepticus

Marina Martinos, Suresh Pujar, Helen O'Reilly, Michelle de Haan, Brian Neville, Rod Scott, Richard Chin

Research output: Contribution to journalArticlepeer-review

Abstract

ABSTRACT
Long term intelligence and memory outcomes of children post Convulsive Status Epilepticus (CSE) have not been systematically investigated despite evidence of short-term impairments in CSE. The present study aimed to describe intelligence and memory outcomes in children within 10 years of CSE and identify potential risk factors for adverse outcomes. In this cohort study, children originally identified by the population-based north London Convulsive Status Epilepticus in childhood surveillance study (NLSTEPSS) were prospectively recruited between July 2009 and February 2013 and invited for neuropsychological assessments and magnetic resonance imaging (MRI) scans. Full-scale intelligence quotients (FSIQ) were measured using the Wechsler Abbreviated Scales of intelligence (WASI) and global memory (GMS) was assessed using the Children’s Memory Scale (CMS). The cohort was analysed as a whole and stratified into a prolonged febrile seizures (PFS) and non-PFS group. Their performance was compared to population norms and controls. Regression models were fitted to identify predictors of outcomes. A mean of 8.9 years post CSE, 28.5% of eligible participants were unable to undertake testing due to their severe neurodevelopmental deficits. CSE children who undertook formal testing (N=94) were shown to have significantly lower FSIQ (p=0.001) and GMS (p=0.025) from controls; the PFS group (N=34) had lower FSIQs (p=0.022) but similar memory quotients (p=0.88) with controls. Intracranial volume (ICV), developmental delay at baseline and active epilepsy at follow up were predictive of long-term outcomes in the non-PFS group. The relationship between ICV and outcomes was absent in the PFS group despite its presence in the control and non-PFS groups. Post-CSE, survivors reveal significant intelligence and memory impairments but prognosis differs by CSE type; memory scores are uncompromised in the PFS group despite evidence of their lower FSIQ whereas both are compromised in the non-PFS group. Correlations between brain volumes and outcomes differ in the PFS, non-PFS and control groups and require further investigation.
Abbreviations: Prolonged febrile seizures (PFS), convulsive status epilepticus (CSE), North London Status Epilepticus Study (NLSTEPSS), full scale intelligence quotient (FSIQ), general memory score (GMS), intracranial volume (ICV).
Keywords: convulsive status epilepticus; prolonged febrile seizures; cognition; memory; long term outcomes; intracranial volume.
Original languageEnglish
JournalEpilepsy & Behavior
DOIs
Publication statusPublished - 19 Apr 2019

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