The relation between learning and memory and epilepsy in school children with recently diagnosed idiopathic and/or cryptogenic seizures was evaluated at Wilhelmina Children’s Hospital, the Netherlands. Word span (imageable nouns) and location learning of colored pictures were assessed within 48 hours after diagnosis of epilepsy and 3 and 12 months later, in 69 school children with epilepsy (aged 9.1 years, SD 2.7) and 66 classmates. Patients and controls performed similarly in registration, recall, and retention. Under conditions of increased demand on working memory (reproducing words in reverse order), patients recalled slightly less than controls; 54% of the epilepsy group, cf 26% of healthy classmates, under-performed in one or other aspects of tasks. Emotional reactions of parent and child to the onset and poor control of epilepsy contributed to impaired memory. Children with a favorable response to therapy did not differ from controls, while those with 6 months of refractory seizures had worse memory spans backwards than controls. School children with new onset idiopathic or cryptogenic epilepsy are vulnerable when processing memory tasks, particularly in tasks of increased demand and when seizures are poorly controlled. [1]

COMMENT. School children with newly diagnosed epilepsy can retain normal learning and memory, but when task difficulty is increased or material reversed, memory may be impaired. This vulnerability to memory impairment is enhanced when patients and parents cannot adapt to the diagnosis of epilepsy or when seizures are poorly controlled. In individual cases, memory under-performance is neither consistent nor persistent, but it is twice as frequent as among controls.

The recognition of these memory impairments should prompt academic accommodations and a more structured classroom environment. Previous investigators have reported that ongoing seizures may impair school performance and memory and learning. Memory deficits and underachievement may be transient (Deonna et al. 2000), or persistent (Austin et al. 1999).