Epilepsia

Objective

Children with epilepsy (EPI) have a higher rate of ADHD (28–70%) than typically developing (TD) children (5–10%); however, attention is multidimensional. Thus, we aimed to characterize the profile of attention difficulties in children with epilepsy.

Methods

Seventy-five children with localization-related epilepsy ages 6–16 and 75 age-matched controls were evaluated using multimodal, multidimensional measures of attention including direct performance and parent ratings of attention as well as intelligence testing. We assessed group differences across attention measures, determined if parent rating predicted performance on attention measures, and examined if epilepsy characteristics were associated with attention skills.

Results

The EPI group performed worse than the TD group on timed and complex attention aspects of attention (p<.05), while performance on simple visual and simple auditory attention tasks was comparable. Children with EPI were 12 times as likely as TD children to have clinically elevated symptoms of inattention as rated by parents, but ratings were a weak predictor of attention performance. Earlier age of onset was associated with slower motor speed (p<.01), but no other epilepsy-related clinical characteristics were associated with attention skills.

Significance

This study clarifies the nature of the attention problems in pediatric epilepsy, which may be under recognized. Children with EPI had difficulty with complex attention and rapid response, not simple attention. As such, they may not exhibit difficulty until later in primary school when demands increase. Parent report with standard ADHD screening tools may underdetect these higher order attention difficulties. Thus, monitoring through direct neuropsychological performance is recommended.

25940056

PMC4457628

Journal Article

CDC Public Access