Cognitive and language function was determined in 16 children (mean age, 9.2 years; range 6-16) with absence epilepsy compared to 16 controls at the University of Catania, Italy. Children with absence epilepsy had subtle but significant deficits in global cognitive functioning (median full-scale IQ_ 90.8 cf 103.2 in controls), and in visuospatial skills, nonverbal memory and delayed recall, while verbal memory and language function was preserved. Patients with early-onset seizures (< age 4 years) had more severe cognitive deficits than those whose epilepsy developed after age 4 years. [1]

COMMENT. Possible factors responsible for the impaired cognitive functioning in absence epilepsy syndrome include the effects of the seizures, the frequency and duration of the seizures, the underlying cause of the epilepsy, and the cognitive effects of antiepileptic drugs. The majority of patients in this study were treated with valproate monotherapy, and the possible adverse effects of the anticonvulsant cannot be discounted. (See Ped Neur Briefs Dec 2000;14:92, for report of study showing adverse effects of valproate on learning, memory, and behavior (Ronen et al. 2000)). The long-term follow-up of patients, comparing those whose seizures remit early and those requiring persistent therapy, would assist in differentiating the cause or causes of the cognitive dysfunction.