Learning Disabilities in Children with Self-limited Epilepsy with Centrotemporal Spikes - A Cohort Study

Abstract

Introduction: Contrary to the benign evolution, the normal intellectual efficiency in children with self-limited epilepsy with centrotemporal spikes (SeLECTS) has been challenged by recent observations of academic backwardness. We aimed to determine the frequency of Specific Learning Disabilities (SLD) in children with SeLECTS.

Methods: This prospective cohort study was conducted in a tertiary care hospital in South India over 12 months. Forty-one children with clinical and electrographic features consistent with SeLECTS (cases) and 41 age-matched healthy controls were recruited. The IQ (Intelligence quotient) of children in both groups was tested by the Malin’s Intelligence Scale for Indian Children and those with normal IQ were subjected to a validated NIMHANS SLD testing battery. Children with a performance below two standards of their expected grade were considered to have a SLD.

Results: The mean age of seizure onset ± standard deviation (± SD) was 7.6 (1.6) years. The mean duration of epilepsy with ± SD was 12 (4.7) months. The EEG spikes distribution was centrotemporal in 63.4% of cases, with a median spike index of 30% (IQR 20 - 39). The mean IQ with ± SD was 81.2 (2.1) % and 81.5 (2.6)% in cases and controls respectively. Specific learning disability was reported in 17 cases (41.5%) and five (12.2%) controls (P = 0.003). Younger children with SeLECTS (5 - 7 years) had a significant occurrence of difficulty in visual memory (P = 0.01). Older children with SeLECTS (8 - 12 years) had difficulties in reading (P = 0.01), spelling (P = 0.03), and reading comprehension (P = 0.02), which were statistically significant.

Conclusion: Children with SeLECTS showed a significant occurrence of SLD as compared to healthy controls.