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Growing up with epilepsy: a two-year investigation of cognitive development in children with new onset epilepsy.

ABSTRACT: To characterize patterns and determinants of normal and abnormal cognitive development in children with new onset epilepsy compared to healthy controls.Longitudinal (2-year) cognitive growth was examined in 100 children, age 8-18 years, including healthy controls (n = 48) and children with new onset epilepsy (n = 52). Cognitive maturation was examined as a function of the presence/absence of two neurobehavioral comorbitiies (attention deficit hyperactivity disorder and/or academic problems) identified at the time of epilepsy diagnosis. Groups were compared across a comprehensive neuropsychological battery assessing intelligence, academic achievement, language, memory, executive function, and psychomotor speed.Children with new onset epilepsy without neurobehavioral comorbidities were comparable to healthy controls at baseline, rate of cognitive development, and follow-up assessment across all neuropsychological domains. In contrast, the presence of neurobehavioral comorbidities was associated with significantly worse baseline and prospective cognitive trajectories across all cognitive domains, especially executive functions.The presence of neurobehavioral comorbidities at the time of epilepsy onset is a major marker of abnormal cognitive development both prior to and after the onset of epilepsy.

SUBMITTER: Hermann BP

PROVIDER: S-EPMC2921826 | biostudies-literature | 2008 Nov

REPOSITORIES: biostudies-literature

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Growing up with epilepsy: a two-year investigation of cognitive development in children with new onset epilepsy.

Hermann Bruce P BP Jones Jana E JE Sheth Raj R Koehn Monica M Becker Tara T Fine Jason J Allen Chase A CA Seidenberg Michael M

Epilepsia 20080910 11

<h4>Purpose</h4>To characterize patterns and determinants of normal and abnormal cognitive development in children with new onset epilepsy compared to healthy controls.<h4>Methods</h4>Longitudinal (2-year) cognitive growth was examined in 100 children, age 8-18 years, including healthy controls (n = 48) and children with new onset epilepsy (n = 52). Cognitive maturation was examined as a function of the presence/absence of two neurobehavioral comorbitiies (attention deficit hyperactivity disorde ...[more]

PMID: 18785880

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Project description:ImportanceThe neurodevelopmental risks of fetal exposure are uncertain for many antiseizure medications (ASMs).ObjectiveTo compare children at 2 years of age who were born to women with epilepsy (WWE) vs healthy women and assess the association of maximum ASM exposure in the third trimester and subsequent cognitive abilities among children of WWE.Design, setting, and participantsThe Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study is a prospective, observational, multicenter investigation of pregnancy outcomes that enrolled women from December 19, 2012, to January 13, 2016, at 20 US epilepsy centers. Children are followed up from birth to 6 years of age, with assessment at 2 years of age for this study. Of 1123 pregnant women assessed, 456 were enrolled; 426 did not meet criteria, and 241 chose not to participate. Data were analyzed from February 20 to December 4, 2020.Main outcomes and measuresLanguage domain score according to the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III), which incorporates 5 domain scores (language, motor, cognitive, social-emotional, and general adaptive), and association between BSID-III language domain and ASM blood levels in the third trimester in children of WWE. Analyses were adjusted for multiple potential confounding factors, and measures of ASM exposure were assessed.ResultsThe BSID-III assessments were analyzed in 292 children of WWE (median age, 2.1 [range, 1.9-2.5] years; 155 female [53.1%] and 137 male [46.9%]) and 90 children of healthy women (median age, 2.1 [range, 2.0-2.4] years; 43 female [47.8%] and 47 male [52.2%]). No differences were found between groups on the primary outcome of language domain (-0.5; 95% CI, -4.1 to 3.2). None of the other 4 BSID-III domains differed between children of WWE vs healthy women. Most WWE were taking lamotrigine and/or levetiracetam. Exposure to ASMs in children of WWE showed no association with the language domain. However, secondary analyses revealed that higher maximum observed ASM levels in the third trimester were associated with lower BSID-III scores for the motor domain (-5.6; 95% CI, -10.7 to -0.5), and higher maximum ASM doses in the third trimester were associated with lower scores in the general adaptive domain (-1.4; 95% CI, -2.8 to -0.05).Conclusions and relevanceOutcomes of children at 2 years of age did not differ between children of WWE taking ASMs and children of healthy women.Trial registrationClinicalTrials.gov Identifier: NCT01730170.

Project description:Objective: To present 8-year follow-up outcomes, treatment of complications, and prognosis in children with congenital tracheal stenosis after metallic airway stent implantation. Methods: Retrospective analysis was performed on the clinical records of children who had airway stents placed between May 20, 2011 and May 31, 2016, and on their follow-up records collected on November 31, 2019. Results: During the 8 years follow-up, 41 children underwent airway stenting under flexible bronchoscopy and participated in the follow-up investigation. There were 26 cases with left main bronchus (LMB) stenosis (63.4%), 16 cases with congenital tracheal stenosis (CTS, 39.0%), 12 cases with right main bronchus (RMB) stenosis (29.3%), and 1 case of subglottic stenosis (2.4%). A total of 76 stents were implanted, and 21 patients died after implantation. There were 34 children (82.9%) with congenital heart disease (CHD), while other diseases accounted for <5%. Among children with CHD and those with other conditions, the number of death cases was 19 and 2, respectively; no significant differences were observed between the two groups (P>0.05). The most frequent complications were increased airway secretion (75.8%), stent deformation (66.7%), and granulation tissue hyperplasia (60.6%). The airway stenosis (45.5%) and stent migration (12.1%) occurred at a moderate rate. The less common complications were airway softening (6.1%), and stent breakage (6.1%). Conclusions: The placement and removal of the metallic stent are convenient and quick procedures that can relieve the symptoms of dyspnea caused by airway stenosis in the case of an emergency. After stent implantation, the primary disease should be actively treated, and the stent should be removed as soon as possible after the cause of airway stenosis is successfully removed. Larger stents are more likely to cause complications; thus, a good follow-up system should be established to timely address all the complications.

Dataset Information

Growing up with epilepsy: a two-year investigation of cognitive development in children with new onset epilepsy.

Publications

Growing up with epilepsy: a two-year investigation of cognitive development in children with new onset epilepsy.

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