Reaction time, attention and impulsivity in 112 children with epilepsy (4.5-13 years) were studied using a computerized test at the Division of Neurology, Children’s Hospital Los Angeles, Los Angeles, CA. Measures included simple reaction time, forced choice reaction time, choice reaction time with distraction, variability of speed of response and errors of omission and commission. Compared to controls, children with epilepsy were significantly slower, more variable and made more omission errors but not commission or impulsive errors. Reaction times showed a negative correlation with IQ but were not related to seizure severity or duration of seizure disorder. Differences related to treatment history were small although patients with less total exposure to antiepileptic medications tended to perform better than those with greater total exposure. A small unmedicated group did not differ from patients on antiepileptic drugs on the day of the test, however. [1]

COMMENT. The authors conclude that the slowed reaction times and inattention demonstrated by epileptic patients were not primarily a result of the seizures or treatment. The names of the specific anticonvulsants were not included. A slowed motor speed may contribute to a relatively low performance IQ score.

Absence seizures may complicate learning disabilities and the diagnosis may be overlooked when using routine EEGs. Borkowski WJ, Jr. et al. at the Alfred I. duPont Institute, Wilmington, DE have demonstrated the value of 24 hour sleep deprivation in the activation of spike and wave discharges in the EEG in 8 of 9 learning impaired children with a history of absence seizures. [2]