Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-23T14:23:20.868Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychological outcomes in children of mothers with epilepsy

Published online by Cambridge University Press:  18 May 2007

ELISA KANTOLA-SORSA ,
EIJA GAILY ,
MIRVA ISOAHO  and
MARIT KORKMAN
ELISA KANTOLA-SORSA
Affiliation:
Hospital for Children and Adolescents, Department of Pediatric Neurology, Helsinki University Central Hospital, Helsinki, Finland
EIJA GAILY
Affiliation:
Hospital for Children and Adolescents, Department of Pediatric Neurology, Helsinki University Central Hospital, Helsinki, Finland
MIRVA ISOAHO
Affiliation:
Hospital for Children and Adolescents, Department of Pediatric Neurology, Helsinki University Central Hospital, Helsinki, Finland
MARIT KORKMAN
Affiliation:
Department of Psychology, Åbo Akademi University, Turku, Finland
Get access Rights & Permissions [Opens in a new window]

Abstract

The study investigated the nature of the effects of maternal epilepsy on cognitive performance of the offspring. One hundred fifty-four children of mothers with epilepsy aged 5 to 11 years (study group), along with 130 control children, comparable with respect to IQ, socio-economic status, age, and gender underwent a neuropsychological assessment using subtests from the NEPSY: A Developmental Neuropsychological Assessment, tapping attentional, auditory-verbal, visuomotor, fine motor, and memory abilities. The study group scored significantly lower than the controls on measures of attention, memory, and fine-motor function. Deficits were more marked in but not limited to the subset of the study group exposed to maternal medication in utero. Group differences on auditory attention were found only in younger children. Valproate-exposed children obtained lower scores on sentence repetition, as well as on the more demanding part of a test of auditory attention, than other children in the study group, suggesting weaknesses in working memory in the former subgroup. Confounding by maternal epilepsy type and polytherapy complicate interpretation of this finding. Differences between subsets of children not exposed to anti-epileptic drugs in utero and controls suggest that both drug exposure and genetic factors may contribute to cognitive deficits associated with maternal epilepsy. (JINS, 2007, 13, 642–652.)

Keywords

Maternal epilepsyAntiepileptic drugsFetal effectsCognitive developmentAttentionWorking memory
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 13 , Issue 4 , July 2007 , pp. 642 - 652
Copyright
© 2007 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Adab, N., Tudur Smith, C., Vinten, J., Williamson, P.R., & Winterbottom, J.J. (2004). Common antiepileptic drugs in pregnancy in women with epilepsy. The Cochrane Databases of Systematic Reviews, Issue 3. Art. No.: CD004848 DOI:10.1002/14651858.CD004848
Aldenkamp, A.P., Alpherts, W.C.J., Dekker, M.J.A., & Overweg, J. (1990). Neuropsychological aspects of learning disabilities in epilepsy. Epilepsia, 41 (Suppl. 4), 9–20.Google Scholar
Aldenkamp, A.P. & Arends, J. (2004). Effects of epileptiform EEG discharges on cognitive function: Is the concept of “transient cognitive impairment” still valid? Epilepsy & Behavior, 5, S25–S34.Google Scholar
Aylward, G.P. (1997). Infant and Early Childhood Neuropsychology. New York and London: Plenum Press.
Binnie, C.D. (1993). Significance and management of transitory cognitive impairment due to subclinical EEG discharges in children. Brain & Development, 15, 23–30.Google Scholar
Commission on Classification and Terminology of the International League Against Epilepsy. (1989). Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia, 30, 389–399.Google Scholar
Dean, J.C.S., Hailey, H., Moore, S.J., Lloyd, D.J., Turnpenny, P.D., & Little, J. (2002). Long term health and neurodevelopment in children exposed to antiepileptic drugs before birth. Journal of Medical Genetics, 39, 251–259.Google Scholar
Duncan, S., Mercho, S., Lopes-Cendes, I., Seni, M.-H., Benjamin, A., Dubeau, F., Andermann, F., & Andermann, E. (2001). Repeated neural tube defects and valproate monotherapy suggest a pharmacogenetic abnormality. Epilepsia, 42, 750–753.Google Scholar
Doose, H., Neubauer, B., & Carlsson, G. (1996). Children with benign focal sharp waves in the EEG—developmental disorders and epilepsy. Neuropediatrics, 27, 227–241.Google Scholar
Eriksson, K., Viinikainen, K., Mönkkönen, A., Äikiä, M., Nieminen, P., Heinonen, S., & Kälviäinen, R. (2005). Children exposed to valproate in utero—Population based evaluation of risks and confounding factors for long-term neurocognitive development. Epilepsy Research, 65, 189–200.Google Scholar
Gaily, E., Kantola-Sorsa, E., & Granström, M.-L. (1988). Intelligence of children of epileptic mothers. The Journal of Pediatrics, 113, 667–684.Google Scholar
Gaily, E., Kantola-Sorsa, E., & Granström, M.-L. (1990). Specific cognitive dysfunction in children with epileptic mothers. Developmental Medicine & Child Neurology, 32, 403–414.Google Scholar
Gaily, E., Kantola-Sorsa, E., Hiilesmaa, V., Isoaho, M., Matila, R., Kotila, M., Nylund, T., Bardy, A., Kaaja, E., & Granström, M.-L. (2004). Normal intelligence in children with prenatal exposure to carbamazepine. Neurology, 62, 28–32.Google Scholar
Hiilesmaa, V. (1996). Effects of maternal seizures on the fetus. In T. Tomson, L. Gram, M. Sillanpää, & S. Johannesen (Eds.), Epilepsy and pregnancy (pp. 135–141). Peterfield, UK and Bristol, PA: Wrightson Biomedical Publishing Ltd.
Holmes, G.L. (2001). Pathogenesis of learning disabilities in epilepsy. Epilepsia, 42 (Suppl. 1), 13–15.Google Scholar
Kheirandish, L., Gozal, D., Pequignot, J.M., Pequignot, J., & Row, B.W. (2005). Intermittent hypoxia during development induces long-term alterations in spatial working memory, monoamines, and dendritic branching in rat frontal cortex. Pediatric Research, 58, 594–599.Google Scholar
Knights, R.M. & Moule, A.D. (1968). Normative data on the motor steadiness battery for children. Perceptual and Motor Skills, 26, 643–650.Google Scholar
Korkman, M. & Häkkinen-Rihu, P. (1994). A new classification of developmental language disorders (DLD). Brain and Language, 47, 96–116.Google Scholar
Korkman, M., Kirk, U., & Kemp, S. (1997). NEPSY Finnish version. Helsinki: Psykologien Kustannus Oy.
Korkman, M., Kirk, U., & Kemp, S. (1998). NEPSY, A Developmental Neuropsychological Assessment. San Antonio, TX: The Psychological Corporation.
Korkman, M. & Peltomaa, K. (1991). A pattern of test findings predicting attention problems at school. Journal of Abnormal Child Psychology, 19, 451–467.Google Scholar
Loring, D.W. & Meador, K.J. (2001). Cognitive and behavioral effects of epilepsy treatment. Epilepsia. 42 (Suppl. 8), 24–32.Google Scholar
Malm, H., Kajantie, E., Kivirikko, S., Kääriäinen, H., Peippo, M., & Somer, M. (2002). Valproate embryopathy in three sets of siblings: Further proof of hereditary susceptibility. Neurology, 59, 630–633.Google Scholar
Morse, S.B., Wu, S.S., Ma, C., Ariet, M., Resnick, M., & Roth, J. (2006). Racial and gender differences in the viability of extremely low birth weight infants: A population-based study. Pediatrics, 117, 106–12.Google Scholar
Olafsson, E., Hallgrimsson, J.T., Hauser, W.A., Ludvigsson, P., & Gudmundsson, G. (1998). Pregnancies of women with epilepsy: A population-based study in Iceland. Epilepsia, 39, 887–892.Google Scholar
Raz, S., Lauterbach, M.D., Hopkins, T.L., Glogowski, B.K., Porter, C.L., Riggs, W.W., & Sander, C.J. (1995). A female advantage in cognitive recovery from early cerebral insult. Developmental Psychology, 31, 958–966.Google Scholar
Rovet, J., Cole, S., Nulman, I., Scolnik, D., Altmann, D., & Koren, G. (1995). Effects of maternal epilepsy on children's neurodevelopment. Child Neuropsychology, 1, 150–157.Google Scholar
Shapiro, S., Slone, D., Hartz, S.C., Rosenberg, L., Siskind, V., Monson, R.R., Mitchell, A.A., & Heinonen, O. (1976). Anticonvulsants and parental epilepsy in the development of birth defects. Lancet, 1, 272–275.Google Scholar
Tilastokeskus (1999). Finnish centre of statistics. Available at web site: http://statfin.stat.fi
Tomson, T., Perucca, E., & Battino, D. (2004). Navigating toward fetal and maternal health: The challenge of treating epilepsy in pregnancy. Epilepsia, 45, 1171–1175.Google Scholar
Vinten, J., Adab, N., Kini, U., Gorry, J., Gregg, J., & Baker, G.A. (2005). Neuropsychological effects of exposure to anticonvulsant medication in utero, Neurology, 64, 949–954.Google Scholar
Wechsler, D. (1984). WISC-R, Wechsler Intelligence Scale for Children–Revised. Manual for the Finnish version. Helsinki: Psykologien Kustannus Oy.
Wechsler, D. (1995). WPPSI-R, Wechsler Preschool and Primary Scale of Intelligence–Revised. Manual for the Finnish version. Helsinki: Psykologien Kustannus Oy.
Wide, K., Hening, E., Tomson, T., & Winbladh, B. (2002). Psychomotor development in preschool children exposed to antiepileptic drugs in utero. Acta Paediatrica, 91, 409–414.Google Scholar
Winawer, M.R. & Shinnar, S. (2005). Genetic epidemiology of epilepsy or what do we tell families. Epilepsia, 46 (Suppl. 10), 24–30.Google Scholar