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12b - A lifespan perspective of cognition in epilepsy

from Section II - Disorders

Published online by Cambridge University Press:  07 May 2010

By
Michael Seidenberg  and
Bruce Hermann
Edited by
Jacobus Donders  and
Scott J. Hunter
Jacobus Donders
Affiliation:
Mary Free Bed Rehabilitation Hospital
Scott J. Hunter
Affiliation:
University of Chicago
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Summary

Introduction

Epilepsy is a chronic neurological disorder, affecting approximately 1% of the population, or over 2 million Americans, with an incidence of 30% of cases younger than age 18 years at diagnosis (see Hauser and Hesdorffer [1]; also see Felix and Hunter, Chapter 12a of this volume). Epilepsy is an umbrella term for various syndromes with distinct profiles of clinical semiology, etiology, age of onset, EEG, and other neurophysiological underpinnings. For many individuals, anti-epileptic drug (AED) treatment provides a successful route to seizure control. However, a significant number of people continue onto an intractable and chronic course which can last for many years, and in some for the better part of their life.

Viewed from a lifespan perspective, childhood-onset chronic epilepsy potentially impacts the early years of brain and cognitive development and also leaves the underlying neurobiological substrate vulnerable to the effects of subsequent insults (i.e. seizures) including the additional impact associated with aging. To date, there have been few attempts to consider the lifespan natural course of epilepsy and its implications for neurobehavioral status. This is the primary objective of this chapter.

Cognitive reserve

The concepts of brain reserve capacity and cognitive reserve were initially proposed as a potential mediator of the cognitive course in older individuals. According to this proposal, individuals have different thresholds for exhibiting neuropsychological and behavioral symptoms in the face of seemingly similar cerebral insults [2].

Type
Chapter
Information
Principles and Practice of Lifespan Developmental Neuropsychology , pp. 371 - 378
Publisher: Cambridge University Press
Print publication year: 2010

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