SAN ANTONIO—Despite having a greater degree of cognitive impairment, adults with early-onset epilepsy may not experience significantly different degrees of psychosocial functioning than those with late-onset epilepsy, researchers reported at the 64th Annual Meeting of the American Epilepsy Society.
Vaishali S. Phatak, PhD, Acting Assistant Professor of Neurology at the University of Washington in Seattle, and colleagues hypothesized that early-onset seizures would lead to greater psychosocial difficulties in adulthood due to increased cognitive disability risk, disruption of school and work, and longer experience with social stigma. To test this hypothesis, the investigators provided comprehensive neuropsychologic evaluations to 47 adults with intractable complex partial seizures and unilateral temporal lobe focus. Fifteen participants had early-onset seizures, defined as seizures starting at age 5 or earlier, and 32 participants had late-onset seizures, defined as seizures after age 5.
The patients’ quality of life was assessed with use of the Washington Psychosocial Inventory (WPSI), a self-report questionnaire. In addition, their intelligence was assessed with the Wechsler Adult Intelligence Scale III (WAIS-III), and their naming ability was assessed with the Boston Naming Test (BNT).
As the researchers expected, patients with early-onset seizures showed greater cognitive impairment than those with late-onset seizures, with mean scores of 43.7 and 50.7, respectively, on the BNT. On average, patients with early-onset seizures had borderline worse WAIS-III scores than did those with late-onset seizures (84.7 vs 93.2, respectively).
The two groups did not have significantly different levels of educational attainment, however. Furthermore, no significant difference in psychosocial functioning was found between the two groups on the WPSI subscales. “Both groups had elevated scores in the clinical range on emotional adjustment, interpersonal adjustment, vocational adjustment, financial adjustment, and adjustment to seizures,” the researchers wrote.
“These findings suggest that an epilepsy diagnosis, rather than age of seizure onset or specific cognitive deficits, affects psychosocial functioning,” the investigators concluded. “Individuals with early-onset seizures may have been able to recruit more coping resources from their environment to compensate for earlier disability such as special education services in school, etc.” The researchers added that adults with early-onset seizures might report fewer psychosocial difficulties because they have become inured to their disabilities.
—Jack Baney