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Developmental delays in children following prolonged seizures

08.04.2013
Researchers from the UK determined that developmental delays are present in children within six weeks following convulsive status epilepticus (CSE)—a seizure lasting longer than thirty minutes.

The study appearing today in Epilepsia, a journal published by Wiley on behalf of the International League Against Epilepsy (ILAE), suggests that neurodevelopmental impairments continue to be present one year after CSE.

CSE is one of the most common neurological emergencies in children. These prolonged seizures can occur with or without fevers (febrile). Studies show that CSE occurs more frequently during the first three years of life—a time of critical growth and development in children. Prior research investigating CSE has focused mainly on simple febrile seizures and was conducted years after the event occurred.

"Our study is the first to examine cognitive, language, and motor function in children within six weeks of CSE, with follow-up at one year to determine their developmental track," said lead author, Dr. Marina Martinos with the Developmental Cognitive Neurosciences Unit at UCL Institute of Child Health in London. "Understanding how CSE impacts early childhood development and whether this type of seizure has long-term adverse affects is an important addition to medical evidence."

For the present study, researchers recruited 54 children between one and forty-two months of age who had at least one CSE event. CSE episodes were classified as prolonged febrile seizures (PFS) or nonfebrile CSE. All pediatric participants underwent neuropsychological assessments and imaging scans within six weeks of the CSE event and at one year. Developmental skills were measured in children who had seizures and compared to children without seizures with normal development.

Half of the pediatric participants had PFS and the other half had nonfebrile CSE, with assessments carried out at a mean of 38 days following CSE. Findings indicate that CSE is linked to developmental impairments within six weeks of the event, and that the impairments persisted at the one-year follow-up. Children with nonfebrile PFS had worse developmental outcomes than those with PFS, and children in the PFS group had poorer developmental skills than those in the control group. The authors found that seizure characteristics (e.g. duration) were not a significant predictor of developmental performance.

Dr. Martinos concludes, "We found developmental impairments in children following CSE, including those with PFS who normally do not display neurologic issues prior to the seizure. The fact that neurodevelopmental impairments are still present at one year after the episode suggests that the CSE event is not having just a transient effect on developmental abilities. The CSE may have a longer lasting impact on future development through a more permanent reorganization of functional brain networks – a reorganization that may have already taken place when we first assess these children."

Alternatively, the authors comment, these data suggest that the neurodevelopmental impairments observed predate the seizure even in those with no neurological priors. The authors propose that further studies that include neurocognitive techniques are necessary to enhance understanding of the long-term impact of CSE on child development.

This study is published in Epilepsia. Media wishing to receive a PDF of the article may contact sciencenewsroom@wiley.com.

Full citation: "Early Developmental Outcomes in Children Following Convulsive Status Epilepticus: A Longitudinal Study." Marina M. Martinos, Michael Yoong, Shekhar Patil, Wui K. Chong, Rodica Mardari, Richard F. M. Chin, Brian G. R. Neville, Michelle de Haan and Rod C. Scott. Epilepsia; Published Online: April 8, 2013 (DOI: 10.1111/epi.12136).

Author Contact: Media wishing to speak with Dr. Martinos may contact Jenny Gimpel at jenny.gimpel@gosh.org.

About the Journal

Epilepsia is the leading, most authoritative source for current clinical and research results on all aspects of epilepsy. As the journal of the International League Against Epilepsy, subscribers every month will review scientific evidence and clinical methodology in: clinical neurology, neurophysiology, molecular biology, neuroimaging, neurochemistry, neurosurgery, pharmacology, neuroepidemiology, and therapeutic trials. For more information, please visit http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1528-1167.

About the International League Against Epilepsy

The International League Against Epilepsy (ILAE) is the world's preeminent association of physicians and health professionals working toward a world where no person's life is limited by epilepsy. Since 1909 the ILAE has provided educational and research resources that are essential in understanding, diagnosing and treating persons with epilepsy. The ILAE supports health professionals, patients, and their care providers, governments, and the general public worldwide by advancing knowledge of epilepsy.

About Wiley

Wiley is a global provider of content-enabled solutions that improve outcomes in research, education, and professional practice. Our core businesses produce scientific, technical, medical, and scholarly journals, reference works, books, database services, and advertising; professional books, subscription products, certification and training services and online applications; and education content and services including integrated online teaching and learning resources for undergraduate and graduate students and lifelong learners.

Founded in 1807, John Wiley & Sons, Inc. (NYSE: JWa, JWb), has been a valued source of information and understanding for more than 200 years, helping people around the world meet their needs and fulfill their aspirations. Wiley and its acquired companies have published the works of more than 450 Nobel laureates in all categories: Literature, Economics, Physiology or Medicine, Physics, Chemistry, and Peace. Wiley's global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company's website can be accessed at http://www.wiley.com.

Dawn Peters | EurekAlert!
Further information:
http://www.wiley.com

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