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Cognitive impairments in children with newly diagnosed epilepsy, including the so-called “benign” epilepsy syndromes, are increasingly recognized clinically.1,2 Previous attempts to characterize the timing and frequency of neuropsychological impairment, as well as identifying factors related to its risk, have been limited by small samples, inattention to important design variables such as appropriate control subjects, or testing children following an extended period between seizure onset and cognitive evaluation.
Using a prospective design in a large community-based cohort of children with newly diagnosed epilepsy with sibling controls, Fastenau et al.3 report a high frequency of cognitive morbidity at the time of epilepsy diagnosis or soon thereafter, providing strong evidence that neuropsychological impairment can be directly attributed to the underlying brain substrate giving rise to the child’s epilepsy rather than a secondary effect from extended exposure to medical therapy or cumulative seizure effects. Slightly more than one-quarter of the patients with …
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