The incidence of mental retardation among those with epilepsy is between 20 and 29 percent, as compared to 1 to 2 percent of the general population. Epilepsy may also affect speech and language, attention, memory, and executive functioning. Each area is described below. These four domains are interrelated and integral to success in school and beyond. If any of these areas is compromised, learning often suffers. Therefore, early recognition of problems in any of these areas is critical, so that parents and teachers can take the appropriate steps to help children achieve their learning goals.
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Learning and daily social interactions depend on communication. Human beings express thoughts, feelings, and desires through both spoken and written language. When speech and language are impaired, learning and socialization are greatly compromised. Although epilepsy increases a child's risk of developing speech and language problems, the particular problems that occur vary according to the location of seizure activity in the brain. Depending on exactly where seizures occur, they may cause a child to have difficulty recognizing speech sounds or understanding what is being said, or have difficulty expressing his or her own ideas or speaking clearly.
Attention is the ability to remain alert and focused on a particular task, while filtering out unimportant stimuli. Critical to the learning process, attention requires the brain to analyze the environment, categorize and organize stimuli as relevant or irrelevant, and focus the mind on the task at hand. Staying attentive is challenging for many children, especially in a busy classroom.
However, some children struggle inordinately with maintaining attention and concentration. Forty percent or more of children with epilepsy may have attention deficits. These problems take many forms and may be related to specific seizure types. For example, children with generalized seizures are more likely to show restlessness and inattentiveness than are children with partial seizures. In addition, some anticonvulsant medications are known to cause attention problems and hyperactivity in some children.
Changing the dosage or type of medication can often reduce or eliminate these problems. The creation of memories is the set of processes by which we store information and experiences. The capacity to remember information and experiences varies from one individual to another and from one experience to another.
For example, emotional moments or stories that pique our curiosity are more easily remembered than are facts that have little emotional significance. Of particular importance to the learning process is what is referred to as working memory. This is the ability to not only access information previously acquired, but also to make generalizations about this information and apply it to other types of situations.
By accessing this prior knowledge, a child acquires a deeper understanding by discovering how the original information fits within the context of other knowledge. The capacity for working memory varies from one individual to another. This disruption may cause children to advance more slowly than their cognitive abilities would otherwise allow. Executive functioning describes the processes of developing and applying systematic approaches to solving problems and challenges.
This is one of the most complex functions that our brains perform. It involves planning, self-regulation, and the ability to think flexibly or creatively. This allows us to consider more than one option, choose one, and then create a plan of action based on past experience, rather than acting on impulse or emotion.
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Executive functioning is critical to a child's ability to access and use other intellectual abilities effectively. Thus, if epilepsy has compromised executive functioning, a child whose basic skills are intact may struggle in the classroom or in communication with others. This problem tends to become more pronounced as children get older and encounter more problem-solving challenges and higher level thinking.
Epilepsy may also be associated with other common learning disabilities, such as those affecting reading, writing, spelling, and math. Such problems are not due to a lack of instruction, nor are they consistent with a child's overall intellectual level. They may be related to some of the dysfunctions previously mentioned, such as cases in which a language problem interferes with a child's ability to read.
However, they may also occur independently. For example, seizures may cause motor control issues that would make it difficult for a child to write letters and words properly. Medications are a critical first line of treatment in the care of people with epilepsy. In most cases, the first drug prescribed controls seizures effectively and causes few, if any, cognitive side effects.
However, in some cases anticonvulsant medications can cause significant cognitive impairment, either because the medication is not well tolerated or because its dosage level is too high. The 8 channels EEG machine used has a low or poor yield compared with machines of higher channels. Although this could be taken as one of the limitations of our study however, many other studies that used high sensitive EEG machines recorded normal results. It could also be due to different sensitivities of different EEG techniques. Waaler et al. Yoshinaga et al.
The cumulative incidence of epileptic discharges was The authors reported This has been attributed to the lower incidence of epileptic discharges in patients with partial seizures than those in patients with generalized seizures This is comparable to adult onset epilepsy in which partial epilepsies were the most frequent types Recent several studies of new onset of seizures showed that the majority of childhood onset epilepsy is localization-related or partial, not generalized, as was not believed in the past.
In a study of Berg et al. In this study, partial epilepsy with secondary generalization was the most frequent type of localization-related epilepsy While complex partial seizure was the least frequent In a community-based study in Ulanga, a rural Tanzanian district, focal seizures with secondary generalization was more common than simple focal seizures Symptomatic group represented We observed that the frontal and temporal lobe epilepsies represented the most frequent types of localization-related epilepsies Al-Sulaiman and Ismail 3 reported that the most reliable EEG abnormalities are the focal spikes or sharp wave discharges over the frontal or temporal lobes.
Chabolla 10 postulated that the temporal and frontal lobes are the most common sites of producing epileptic discharges. We identified 7 age specific epileptic syndromes in In this study, the rolandic epilepsy or benign epilepsy with centrotemporal spikes represented the most frequent type of them Onsurbe Ramirez et al. Benign childhood syndromes have no impact in child development Benign childhood epilepsy with occipital paroxysms was diagnosed with great probability in only 7.
It has been suggested that the EEG of the syndrome of idiopathic partial epilepsy with occipital paroxysms shows a considerable clinical and prognostic heterogeneity. The semiology of seizures varies considerably among patients and the blocking by eye opening which is considered the hallmark of this type of epilepsy is non-specific as it may appear in other idiopathic or symptomatic epilepsies of childhood and even in non epileptic disorders, notably basilar migraine Lennox-Gastaut syndrome LGS represented This is in contrast to Markand et al.
LGS is one of the catastrophic disorders which have a remarkably positive effect on development The results of this study proposed the need for 1 Long-term population epidemiological outcome studies aimed to clarify the prevalence of seizure disorders and to identify and classify epilepsy disorders in children group of population in our locality as this will be of value in early management according to the available resources.
Furthermore, this knowledge will facilitate early educational intervention and multidisciplinary therapeutic and rehabilitation approaches. Percentage was calculated from the number in each category.
Table 3 : Characteristics of the studies group of patients: categorization in relationship with the etiology and type of seizures. Epilepsy and other convulsive disorders in Saudia Arabia: a prospective study of 1, consecutive cases. Acta Neurol Scand. Clinical pattern of newly-diagnosed seizures in Saudia Arabia: a prospective study of children. Childs Nerv Syst. Profile of childhood epilepsy in Bangladesh.
Dev Med Child Neurol. Prevalence of childhood epilepsy in Estonia. Epilepsia ;40 7 Classification of childhood epilepsy syndromes in newly diagnosed epilepsy: interrater agreement and reasons for disagreement. A general hospital population of a childhood epilepsy. Acta Paediatr. Epilepsy: Epilepsies of childhood onset. In: Handbook of epilepsy, 3rd edition. A population-based study of children. Characteristics of the epilepsies.
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