Childhood Absence Epilepsy and Cognitive Function

Childhood absence epilepsy (CAE) is a common paediatric epilepsy syndrome characterised by brief, sudden lapses of consciousness accompanied by bilateral, synchronous 3 Hz spike-and-wave discharges on electroencephalography. Although traditionally regarded as a benign condition with normal cognitive development, increasing evidence has revealed subtle but clinically significant neuropsychological comorbidities. Affected children may exhibit reductions in full-scale, verbal and performance IQ relative to peers, often by five to ten points, and show impairments in attention, processing speed and executive domains such as cognitive flexibility, planning and verbal fluency. Interictal discharges may disrupt neural networks involved in memory and learning and contribute to school difficulties, behavioural problems and mood disturbances. The risk of persistent cognitive deficits appears to relate to seizure frequency, duration of epilepsy and load of interictal spikes, as well as the choice and timing of anticonvulsant therapy. Recent advances in neuroimaging, electrophysiological source analysis and digital cognitive training are refining our understanding of the pathophysiology and opening prospects for targeted interventions to support academic and psychosocial outcomes.

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Childhood Absence Epilepsy and Cognitive Function publication trend

The graph below shows the total number of articles in childhood absence epilepsy and cognitive function across all publications each year (not limited to Nature Index journals).

Technical terms

Childhood absence epilepsy (CAE): A paediatric idiopathic generalised epilepsy syndrome marked by brief absence seizures and distinctive spike-and-wave EEG patterns.

Electroencephalogram (EEG): A non-invasive recording of electrical brain activity, essential for detecting absence seizures and interictal discharges.

Interictal spike load (IISL): The frequency and distribution of epileptiform discharges between seizures, implicated in cognitive disruptions.

Executive function: Higher-order cognitive processes including planning, cognitive flexibility, working memory and inhibitory control.

Processing speed: The rate at which an individual perceives, processes and responds to information, often measured by timed tasks.

Antiepileptic drug (AED): A medication used to prevent or reduce the frequency of epileptic seizures.

References

1. Towards a Better Understanding of Cognitive Deficits in Absence Epilepsy: a Systematic Review and Meta-Analysis. Neuropsychology Review (2019).
2. The interictal activities load and cognitive performance of children with typical absence epilepsy. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery (2021).
3. Feasibility of a Mobile Cognitive Intervention in Childhood Absence Epilepsy. Frontiers in Human Neuroscience (2016).